Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Arthritis in an Ethnically Diverse Systemic Lupus Erythematosus Population.

Respicio1,  Guada, Cleveland1,  Clare, Taylor1,  Kim, Criswell2,  Lindsey A.

Rosalind Russell Medical Research Center for Arthritis, University of California, San Francisco, San Francisco, CA
UCSF-Box 0500, San Francisco, CA

Purpose:

Arthritis is one of the most common manifestations of SLE with reported prevalence ranging from 70–95%. Previous research documents ethnic differences in risk and outcome, however ethnic differences in arthritis in SLE have not been well characterized. Further, clinical, laboratory and other correlates of arthritis in SLE have not been fully investigated. We studied the frequency of arthritis among a large and ethnically diverse lupus cohort, as well as factors associated with the presence of this specific disease manifestation.

Methods:

SLE patients were recruited from various sources, including specialty clinics and practices, community sources and nationwide outreach. The presence of arthritis as well as other ACR classification criteria was documented by review of medical records. Information about ethnic background was based on self report information as well as genotyping results for a set of ancestry informative markers (AIMs, n = 384). Chi square testing was used to identify ethnic differences in presence of arthritis. Other factors associated with arthritis were examined using multivariate logistic regression. Correlation analysis was used to identify patterns of association between arthritis and other disease manifestations with results displayed visually as heat maps.

Results:

2129 SLE patients were studied, including 1201 (56%) Caucasians, 297 (14%) Hispanics, 259 (12%) Asian/Pacific Islanders, and 248 (12%) African Americans (AA). 91% of patients were female, the average age at SLE diagnosis was 33 years, and the average disease duration at study entry was 9 years. Analyses demonstrated statistically significant ethnic differences in arthritis (p = 0.003), with the highest prevalence of arthritis documented for AA patients (75%) and lowest prevalence among Asian patients (59%). Among AA patients, analysis of AIM data did not demonstrate a significant association between the percent African ancestry and risk of arthritis. Results of multivariate logistic regression analyses as well as heat maps representing the degree of correlation between arthritis and other clinical manifestations revealed differential clustering of disease features across ethnic groups. Table 1 summarizes clinical features significantly associated with arthritis based on multivariate analyses of individual ethnic groups. Independent variables in these models included disease duration, sex, and the other ACR classification criteria.

Conclusions:

These results demonstrate ethnic differences in risk of arthritis among SLE patients, with Asian patients having relatively lower risks of arthritis and AA patients having the highest risk of arthritis. Additional research will be required to further define the basis for these ethnic differences in disease expression.

Table 1. Multivariate analyses of ACR Clinical Criteria Associated with Lupus Arthritis

Ethnic GroupSignificant clinical criteria (OR, p value)
CaucasiansMalar rash (1.39, 0.021)
 Serositis (1.70, 0.001)
African-AmericansDiscoid rash (0.355, 0.019)
 Oral ulcers (2.72, 0.042)
 Renal (0.681, 0.024)
HispanicsDiscoid rash (0.231, 0.003)
 Renal (0.711, 0.023)
Asians/Pacific IslandersNone significant

To cite this abstract, please use the following information:
Respicio, Guada, Cleveland, Clare, Taylor, Kim, Criswell, Lindsey A.; Arthritis in an Ethnically Diverse Systemic Lupus Erythematosus Population. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :446
DOI: 10.1002/art.28215

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