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.
Mortality in a Multinational Inception Cohort of SLE.
Urowitz33, Murray B., Gladman22, Dafna D., Ibanez32, Dominique, Gordon29, Caroline P., Bae6, Sang-Cheol, Clarke15, Ann E., Bernatsky15, Sasha R.
West Hollywood, CA
Kantonsspital Schaffhausen, Schaffhausen, Switzerland
Karolinska University Hospital
Landspitalinn University Hospital
Manchester Royal Infirmary, Manchester, United Kingdom
Medical University South Carolina, Charleston, SC
Montreal General Hospital, Montreal, QC, Canada
North West Wales NHS Trust, Colwyn Bay, United Kingdom
Northwestern University, Chicago, IL
Oklahoma Med Research Foundation, Oklahoma City, OK
Queen Elizabeth II Health Services Center, Halifax, NS, Canada
SUNY-Downstate Medical Center, Brooklyn, NY
The Rayne Institute, London, United Kingdom
Toronto Western Hospital, Toronto, ON, Canada
UAB Rheumatology, Birmingham, AL
UCL Div of Medicine, London, United Kingdom
UCL Div of Medicine
UCSD School of Medicine, La Jolla, CA
University Hospital Lund, Lund, Sweden
University of Alabama, Oakland, CA
University of Birmingham, Birmingham, United Kingdom
Emory University, Atlanta, GA
University of Manitoba, Winnipeg, MB, Canada
University of North Carolina at Chapel Hill, Chapel Hill, NC
University of Toronto Lupus Clinic, Toronto Western Hospital
University of Toronto Lupus Clinic, Toronto Western Hospital, Toronto, ON, Canada
West Penn Allegheny Health System, Pittsburgh, PA
Feinstein Institute, Manhasset, NY
Hairmyres Hospital, East Kilbride, United Kingdom
Hanyang University Medical Center, Seoul, Korea, Republic of
Hospital Clinico I Provincial
Hospital de Cruces, Universidad del Pais Vasco
Instituto Nacional Nutricion, Mexico City, DF, Mexico
A large multicentre multinational inception cohort was established to study risk factors for atherosclerosis (AS) in SLE. This study describes survival, mortality and causes of death during the first 10 years of observation of the SLICC inception cohort.
Patients enter the cohort within 15 months of SLE diagnosis (>=4 ACR criteria). Clinical and laboratory features of SLE and comorbidities are gathered in a standardized protocol at yearly intervals. Deaths are recorded as they occur and the cause of death is determined according to the ICD9 code. Demographic and disease related factors present at enrolment were compared in patients who died and in survivors using descriptive statistics, Kaplan-Meier curve as well as life table analysis.
Since 2000, 1593 patients have been entered into the cohort (89.4%F, age at SLE 34.6y, mean followup of 3.7 years). 30 patients have died during the course of follow-up. Survival was 99.6% at 1 year, 98.4% at 3 years and 97.5% at 5 years (figure 1)
Causes of death included coronary artery disease (CAD) in 7, SLE in 9, infection in 9, 1 from other causes and 4 unknown. Patients who died were older at diagnosis, more often had CAD, and had higher SLICC/ACR damage index scores at enrolment and a decreased physical components score (PCS) of the SF-36 at enrolment. Patients who died were also more likely to have used corticosteroids (HR=6.4 p=0.01) and immunosuppressives(HR=2.4 p=0.02) and less likely to have used antimalarials(HR=0.3 p=0.001) at enrolment.
This multinational inception cohort of SLE patients demonstrates the improved survival noted among patients with SLE. Causes of death in the first 10 years of observation of the SLICC inception cohort with an average followup of 3.7 years include CAD, SLE and sepsis. Even early on in the course of SLE, CAD is an important cause of death. Older age, history of CAD, early damage and impaired physical function, use of corticosteroids and immunosuppressives are associated with mortality.
To cite this abstract, please use the following information:
Urowitz, Murray B., Gladman, Dafna D., Ibanez, Dominique, Gordon, Caroline P., Bae, Sang-Cheol, Clarke, Ann E., et al; Mortality in a Multinational Inception Cohort of SLE. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :2240