RESEARCH - Differences in long-term disease activity and treatment of adult patients with childhood- and adult-onset SLE

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Arthritis Rheum. 2008 Dec 30;61(1):13-20. [Epub ahead of print]

Differences in long-term disease activity and treatment of adult

patients with childhood- and adult-onset systemic lupus erythematosus.

Hersh AO, von Scheven E, Yazdany J, Panopalis P, Trupin L, n L,

Katz P, Criswell LA, Yelin E.

University of California, San Francisco.

OBJECTIVE: To compare differences in long-term outcome between adults

with childhood-onset (age at diagnosis <18 years) systemic lupus

erythematosus (SLE) and with adult-onset SLE.

METHODS: Data were derived from the University of California Lupus

Outcomes Study, a longitudinal cohort of 885 adult subjects with SLE

(90 childhood-onset [cSLE], 795 adult-onset [aSLE]). Baseline and

1-year followup data were obtained via structured 1-hour telephone

interviews conducted between 2002 and 2006. Using self-report data,

differences in organ involvement and disease morbidity, current

disease status and activity, past and current medication use, and

number of physician visits were compared, based on age at diagnosis of

SLE.

RESULTS: Average disease duration for the cSLE and aSLE subgroups was

16.5 and 13.4 years, respectively, and mean age at followup was 30.5

and 49.9 years, respectively. When compared with aSLE subjects, cSLE

subjects had a higher frequency of SLE-related renal disease, whereas

aSLE subjects were more likely to report a history of pulmonary

disease. Rates of clotting disorders, seizures, and myocardial

infarction were similar between the 2 groups. At followup, cSLE

subjects had lower overall disease activity, but were more likely to

be taking steroids and other immunosuppressive therapies. The total

number of yearly physician visits was similar between the 2 groups,

although cSLE subjects had a higher number of nephrology visits.

CONCLUSION: This study demonstrates important differences in the

outcomes of patients with cSLE and aSLE, and provides important

prognostic information about long-term SLE disease activity and

treatment.

PMID: 19116979

http://www.ncbi.nlm.nih.gov/pubmed/19116979

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