Hispanics May Be at Increased Risk of Early Lupus Damage

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Hispanics May Be at Increased Risk of Early Lupus Damage

NEW YORK (Reuters Health) Jan 10 - The results of a recent study suggest that

damage in systemic lupus erythematosus (SLE) accrues from the outset in some but

not all patients. While disease-related variables are important, age, ethnicity

and illness-related behaviors may also contribute to overall damage in the

disease.

Dr. Graciela S. Alarcon, of the University of Alabama at Birmingham, and

colleagues examined the factors predictive of damage in a multiethnic LUMINA

(lupus in minority populations, nature versus nurture) series of SLE patients.

The subjects had SLE for no more than 5 years at baseline.

The researchers measured variables at baseline and annually thereafter. The

Systemic Lupus International Collaborating Clinics Damage Index (SDI) was used

to measure disease damage and the Systemic Lupus Activity Measure was used to

measure disease activity.

" The relationship between the different variables and the SDI at the last

visit...was examined, " the team explains in the December issue of Arthritis and

Rheumatism.

Seventy-two Hispanics, 104 African Americans, and 82 Caucasians were included in

the study. While about half of the patients had not accrued any damage, 61% of

Hispanics, 51% of African Americans, and 44% of Caucasians had accrued some

damage by the final follow-up. Caucasians had the lowest baseline SDI scores and

Hispanics had the highest scores after a mean follow-up of 61 months.

The investigators report that Hispanics and African Americans experienced more

renal damage than Caucasians, and integument damage was more prevalent among

African Americans. All patients experienced high levels of neuropsychiatric

(20%), renal (16%) and ocular (15%) damage.

Age, corticosteroid use, number of American College of Rheumatology criteria

met, disease activity, and abnormal illness-related behaviors were independent

predictors of SDI at the final follow-up.

" Other variables were less consistently associated with damage accrual (poverty

in African Americans, lack of HLA-DRB1*0301 in Hispanics, presence of

HLA-DQB1*0201 and acute outset of SLE in Caucasians), " Dr. Alarcon and

colleagues report.

Based on these findings, the researchers suggest that while disease- and

treatment-related variables are important in SLE, " psychological and

sociodemographic features may also contribute to overall damage. " Dr. Alarcon's

group therefore urges clinicians to consider these other risk factors in

managing patients with SLE.

Arthritis Rheum 2001;44:2797-2806.