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Article: Damage accrual in southern Chinese patients with systemic lupus erythematosus

TitleDamage accrual in southern Chinese patients with systemic lupus erythematosus
Authors
Issue Date2003
PublisherJournal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.com
Citation
Journal Of Rheumatology, 2003, v. 30 n. 7, p. 1513-1519 How to Cite?
AbstractObjective. To study the predictive factors of damage accrual in a large cohort of southern Chinese patients with systemic lupus erythematosus (SLE). Methods. A cohort of consecutive Chinese patients with SLE was recruited in 1998 and prospectively followed for 3 years. Demographic data, disease manifestations and activity, medication use, and damage scores were recorded. Organ damage was assessed using the SLE International Collaborating Clinics Damage Index (SDI), which was scored at study entry and then annually. Disease flares and new damage were recorded during followup visits. Predictive factors of new damage were studied by statistical analysis. Results. The cohort consisted of 242 consecutive patients with SLE (221 women, 21 men; F:M = 10.5: 1). All fulfilled at least 4 American College of Rheumatology criteria for the classification of SLE. At entry, mean age was 35.7 ± 10.7 years and mean disease duration was 75.3 ± 79 months. Ninety (38%) patients had damage. The mean SDI score at year 0 was 0.76 ± 1.3 (range 0-8), and this increased significantly to 1.33 ± 1.7 (range 0-9) at year 3 (p < 0.001). The most frequent organ damage at entry was musculoskeletal (26.5%), followed by damage in central nervous system (18.4%), renal (15.1%), and cardiovascular (12.4%) systems. The increase in SDI scores over the 3 year period was primarily caused by the increase in renal, musculoskeletal, and gonadal damage. Twelve patients died. Multiple regression revealed that the number of major disease flares and the use of cyclophosphamide were independent factors predictive of damage accrual. An increase in SDI scores was associated with mortality risk (OR 1.47 per 1 point, 95% CI 1.03-2.11, p = 0.04). Conclusion. The damage scores of our SLE cohort increased significantly over 3 years. Severe disease flares and the use of cyclophosphamide predicted new damage. Increase in damage was associated with mortality risk. Judicious use of immunosuppressive agents to achieve prompt control of disease activity was essential in minimizing damage and improving survival of our patients with SLE.
Persistent Identifierhttp://hdl.handle.net/10722/162696
ISSN
2015 Impact Factor: 3.236
2015 SCImago Journal Rankings: 1.225
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMok, CCen_US
dc.contributor.authorHo, CTKen_US
dc.contributor.authorWong, RWSen_US
dc.contributor.authorLau, CSen_US
dc.date.accessioned2012-09-05T05:22:26Z-
dc.date.available2012-09-05T05:22:26Z-
dc.date.issued2003en_US
dc.identifier.citationJournal Of Rheumatology, 2003, v. 30 n. 7, p. 1513-1519en_US
dc.identifier.issn0315-162Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/162696-
dc.description.abstractObjective. To study the predictive factors of damage accrual in a large cohort of southern Chinese patients with systemic lupus erythematosus (SLE). Methods. A cohort of consecutive Chinese patients with SLE was recruited in 1998 and prospectively followed for 3 years. Demographic data, disease manifestations and activity, medication use, and damage scores were recorded. Organ damage was assessed using the SLE International Collaborating Clinics Damage Index (SDI), which was scored at study entry and then annually. Disease flares and new damage were recorded during followup visits. Predictive factors of new damage were studied by statistical analysis. Results. The cohort consisted of 242 consecutive patients with SLE (221 women, 21 men; F:M = 10.5: 1). All fulfilled at least 4 American College of Rheumatology criteria for the classification of SLE. At entry, mean age was 35.7 ± 10.7 years and mean disease duration was 75.3 ± 79 months. Ninety (38%) patients had damage. The mean SDI score at year 0 was 0.76 ± 1.3 (range 0-8), and this increased significantly to 1.33 ± 1.7 (range 0-9) at year 3 (p < 0.001). The most frequent organ damage at entry was musculoskeletal (26.5%), followed by damage in central nervous system (18.4%), renal (15.1%), and cardiovascular (12.4%) systems. The increase in SDI scores over the 3 year period was primarily caused by the increase in renal, musculoskeletal, and gonadal damage. Twelve patients died. Multiple regression revealed that the number of major disease flares and the use of cyclophosphamide were independent factors predictive of damage accrual. An increase in SDI scores was associated with mortality risk (OR 1.47 per 1 point, 95% CI 1.03-2.11, p = 0.04). Conclusion. The damage scores of our SLE cohort increased significantly over 3 years. Severe disease flares and the use of cyclophosphamide predicted new damage. Increase in damage was associated with mortality risk. Judicious use of immunosuppressive agents to achieve prompt control of disease activity was essential in minimizing damage and improving survival of our patients with SLE.en_US
dc.languageengen_US
dc.publisherJournal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.comen_US
dc.relation.ispartofJournal of Rheumatologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAge Of Onseten_US
dc.subject.meshAsian Continental Ancestry Groupen_US
dc.subject.meshChina - Ethnologyen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshCyclophosphamide - Therapeutic Useen_US
dc.subject.meshDisease Progressionen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunosuppressive Agents - Therapeutic Useen_US
dc.subject.meshLupus Erythematosus, Systemic - Drug Therapy - Epidemiology - Physiopathologyen_US
dc.subject.meshMaleen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.subject.meshSurvival Rateen_US
dc.titleDamage accrual in southern Chinese patients with systemic lupus erythematosusen_US
dc.typeArticleen_US
dc.identifier.emailLau, CS:cslau@hku.hken_US
dc.identifier.authorityLau, CS=rp01348en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid12858450-
dc.identifier.scopuseid_2-s2.0-0038166875en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038166875&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume30en_US
dc.identifier.issue7en_US
dc.identifier.spage1513en_US
dc.identifier.epage1519en_US
dc.identifier.isiWOS:000184061100020-
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridMok, CC=7102344226en_US
dc.identifier.scopusauthoridHo, CTK=7404652632en_US
dc.identifier.scopusauthoridWong, RWS=34875928200en_US
dc.identifier.scopusauthoridLau, CS=14035682100en_US

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