RESEARCH - The 1000 Canadian faces of lupus: determinants of disease outcome in a large multiethnic cohort

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J Rheumatol. 2009 Jun;36(6):1200-8. Epub 2009 Apr 15.

The 1000 Canadian faces of lupus: determinants of disease outcome in a

large multiethnic cohort.

Peschken CA, Katz SJ, Silverman E, Pope JE, Fortin PR, Pineau C,

CD, Arbillaga HO, Gladman DD, Urowitz M, Zummer M, e A, Bernatsky

S, Hudson M; Canadian Network for Improved Outcomes in Systemic Lupus

Erythematosus (CaNIOS).

Collaborators (30)

Craig A, Claudio J, Hewitt S, Ouimet J, Moyen M, Tobaly M, Santopietro

T, Ferland D, Simpson S, K, Hong T, MacLeod M, Wehlage A,

Bernstein J, McKenzie T, GS, Albert L, Carette S, Inman RD,

Hitchon C, Tucker L, Petty R, Chedéville G, Campillo S, Duffy K,

Scuccimarri R, Baron M, Berkson L, Ramsey S, Huber A.

Department of Medicine, University of Manitoba Arthritis Center,

RR149-800 Sherbrook Street, Winnipeg, Manitoba R3A 1M4, Canada.

OBJECTIVE: To describe disease expression and damage accrual in

systemic lupus erythematosus (SLE), and determine the influence of

ethnicity and socioeconomic factors on damage accrual in a large

multiethnic Canadian cohort.

METHODS: Adults with SLE were enrolled in a multicenter cohort. Data

on sociodemographic factors, diagnostic criteria, disease activity,

autoantibodies, treatment, and damage were collected using

standardized tools, and results were compared across ethnic groups. We

analyzed baseline data, testing for differences in sociodemographic

and clinical factors, between the different ethnic groups, in

univariate analyses; significant variables from univariate analyses

were included in multivariate regression models examining for

differences between ethnic groups, related to damage scores.

RESULTS: We studied 1416 patients, including 826 Caucasians, 249

Asians, 122 Afro-Caribbeans, and 73 Aboriginals. Although the overall

number of American College of Rheumatology criteria in different

ethnic groups was similar, there were differences in individual

manifestations and autoantibody profiles. Asian and Afro-Caribbean

patients had more frequent renal involvement and more exposure to

immunosuppressives. Aboriginal patients had high frequencies of

antiphospholipid antibodies and high rates of comorbidity, but disease

manifestations similar to Caucasians. Asian patients had the youngest

age at onset and the lowest damage scores. Aboriginals had the least

education and lowest incomes. The final regression model (R2=0.27) for

higher damage score included older age, longer disease duration, low

income, prednisone treatment, higher disease activity, and

cyclophosphamide treatment.

CONCLUSION: There are differences in lupus phenotypes between ethnic

populations. Although ethnicity was not found to be a significant

independent predictor of damage accrual, low income was.

PMID: 19369456

http://www.ncbi.nlm.nih.gov/pubmed/19369456

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