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Longitudinal disease- and steroid-related damage among adults with childhood-onset systemic lupus erythematosus.


ABSTRACT: OBJECTIVES:Determine whether adults with childhood-onset systemic lupus erythematosus (cSLE) are at increased risk for disease- and steroid-related damage as compared to individuals with adult-onset SLE (aSLE), and whether they continue to accumulate disease damage in adulthood. METHODS:Data derive from the 2007-2015 cycles of the Lupus Outcomes Study, a longitudinal cohort of adults with confirmed SLE. The Brief Index of Lupus Damage (BILD), a validated, patient-reported measure, was used to assess SLE-associated damage. Participants with baseline BILD were included (N?=?1035). Diagnosis at age < 18 years was defined as cSLE (N?=?113). Outcome variables included BILD score at baseline and follow-up, clinically significant change in BILD score over follow-up period, and presence of steroid-related damage (cataracts, osteoporosis-related fracture, avascular necrosis or diabetes mellitus). RESULTS:Mean time between baseline and follow up BILD assessment was 6.3?±?1.7 years. In adjusted analyses, participants with cSLE and aSLE had similar levels of disease-related damage, and accumulated damage at similar rates. Participants with cSLE were more likely to report steroid-related damage (OR 1.7, 95% CI 1.1-2.8) in the adjusted analysis as compared to those with aSLE. Likelihood of steroid-related damage increased with disease duration for both groups, but was consistently higher among cSLE participants. CONCLUSION:In this longitudinal cohort of adults with SLE, participants continued to accumulate damage at similar rates over time, regardless of age at onset or disease duration. Childhood-onset predicted increased risk of steroid-related damage. Aggressive use of steroid-sparing treatment strategies during childhood may be important to prevent steroid-related damage in adulthood.

SUBMITTER: Heshin-Bekenstein M 

PROVIDER: S-EPMC7480934 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Longitudinal disease- and steroid-related damage among adults with childhood-onset systemic lupus erythematosus.

Heshin-Bekenstein Merav M   Trupin Laura L   Yelin Ed E   von Scheven Emily E   Yazdany Jinoos J   Lawson Erica F EF  

Seminars in arthritis and rheumatism 20190603 2


<h4>Objectives</h4>Determine whether adults with childhood-onset systemic lupus erythematosus (cSLE) are at increased risk for disease- and steroid-related damage as compared to individuals with adult-onset SLE (aSLE), and whether they continue to accumulate disease damage in adulthood.<h4>Methods</h4>Data derive from the 2007-2015 cycles of the Lupus Outcomes Study, a longitudinal cohort of adults with confirmed SLE. The Brief Index of Lupus Damage (BILD), a validated, patient-reported measure,  ...[more]

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