Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Michigan Lupus Epidemiology & Surveillance Program (MILES): Increased Proportion of Target-Organ Threatening Involvement Among Male Versus Female SLE Patients

Somers1,  Emily C., Marder1,  Wendy, Lewis1,  Emily E., Francis1,  Sheeja, Cagnoli1,  Patricia C., DeGuire2,  Peter, Gordon3,  Caroline

University of Michigan, Ann Arbor, MI
Michigan Department of Community Health, Lansing, MI
University of Birmingham, Birmingham, United Kingdom
Centers for Disease Control and Prevention, Atlanta, GA
Henry Ford Health System, Detroit, MI
Wayne State University, Bloomfield Hills, MI

Purpose:

Although SLE disproportionately affects women (female to male ratio ~9:1), anecdotal evidence suggests males with SLE have particularly aggressive disease. We compare SLE characteristics in males vs. females utilizing a population-based registry.

Methods:

As part of the ongoing MILES active surveillance program, detailed record reviews are performed for all SLE cases residing in the catchment area (source population ~2.5 million) and meeting eligibility criteria. Two-sided t-tests and chi-squared statistics were performed to compare summary statistics.

Results:

Of the n=1928 currently confirmed SLE patients fulfilling >=4 ACR criteria, 183 (9.5%) were male. The total number of ACR criteria was similar between sexes (mean±SD: F 5.6±1.4, M 5.4±1.5; p=NS), as was age at diagnosis (F 33.5±13.1 yrs, M 35.0±16.1; p=NS). However, males on average had a significantly shorter disease duration (defined as time from diagnosis until most recent follow-up: F 12.3 ± 9.0 vs M 9.9 ± 8.2 yrs, p=0.002).

ACR criteria among SLE patients, according to sex

 Female n=1745 no. (%)Male n=183 no. (%)P-value
Malar889 (51.0)*72 (39.3)0.003
Discoid399 (22.9)51 (27.9)NS
Photosensitivity882 (50.6)*59 (32.4)<0.001
Mucosal ulcers795 (45.8)*46 (25.1)<0.001
Arthritis1,329 (76.2)*122 (67.0)0.006
Serositis751 (43.0)75 (41.0)NS
Renal535 (30.7)78 (42.6)*0.001
Neurologic307 (17.6)47 (25.7)*0.007
Hematologic1,041 (59.7)124 (67.8)*0.033
ANA1,639 (94.7)170 (94.4)NS
Immunologic1,125 (64.5)141 (77.1)*0.001
* designates sex with significantly greater proportion positive for criterion

Conclusion:

Though females had a significantly higher proportion of skin and joint manifestations, males had significantly higher end-organ threatening involvement (renal, neurologic) and both immunologic and hematologic manifestations, which accumulated during a shorter average disease duration. These data support anecdotal evidence that males have more aggressive disease.

To cite this abstract, please use the following information:
Somers, Emily C., Marder, Wendy, Lewis, Emily E., Francis, Sheeja, Cagnoli, Patricia C., DeGuire, Peter, et al; Michigan Lupus Epidemiology & Surveillance Program (MILES): Increased Proportion of Target-Organ Threatening Involvement Among Male Versus Female SLE Patients [abstract]. Arthritis Rheum 2009;60 Suppl 10 :302
DOI: 10.1002/art.25385

Abstract Supplement

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