Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

The Influence of Age of Onset of Systemic Lupus Erythematosus and Disease Duration on Lupus Manifestations.

Ghanim1,  Nayef Al, Su2,  Jiandong, Aghdassi3,  Ellie, Lou1,  Wendy, Fortin4,  Paul R.

University of Toronto, Toronto, ON
The Toronto Western Hospital, Toronto, ON
University Health Network, Toronto, ON
Toronto Western Hospital, Toronto, ON


To investigate the influence of age of Systemic Lupus Erythematosus (SLE) onset and disease duration on the SLICC damage index (SDI).


Patients were identified from a single large lupus registry if they met four of the American College of Rheumatology classification criteria or 3 criteria and lupus histology on skin or kidney tissue. Patients were divided into two groups based on age of onset at diagnosis of SLE with Early onset (EOS) defined as those with SLE diagnosis between the ages 18 and 47 and Late onset SLE (LOS) at age 48 and more. We limited this study to an inception cohort defined as all those entered into the registry within one year of SLE diagnosis. Data on demographics, age at enrollment, SDI items and total score were collected. Chi-square tests were used to compare categorical variables. SLICC items were summarized by organ systems and then converted to a binary variable (0= negative, 1= score of 1 or more). The total SLICC scores in the two groups were compared using Wilcoxon Rank Sum test.


Our sample included 653 patients with 514 EOS and 139 LOS. The majority of patients were female in both groups (88.1% in EOS vs. 82.0% in LOS; p=0.058). Caucasians were represented more in LOS (82.0% in LOS vs 69.9% in EOS; p=0.005). At 5 years follow-up, LOS patients were more likely to have cardiovascular manifestations (18% in LOS vs 6% in EOS. p=0.005). At 10 years follow-up, LOS patients have higher rate of ocular (28.9% vs 13.2%. p=0.01) and cardiovascular manifestations (23.7% vs 7.9%. p=0.005). There was no statistically significant difference in renal manifestations. Total mean SDI score was 1 in both groups at 5 and 10 years follow-up (p=NS). Comparing SDI manifestations over time (at the fifth versus the tenth year), EOS developed significantly more damage at the tenth year in ocular (9.8% vs 15.2%, respectively; p=0.01), cardiovascular (7.1% vs 10.7%; p=0.04), musculoskeletal (17% vs 26.8%; p=0.0009) and dermatological (3.6% vs 8%; p=0.02) organ systems. Similarly, LOS developed significantly more damage at the tenth year in musculoskeletal (9.1% vs 27.3%; p=0.04). In both groups, the total SLICC score increased from 0 to 1 over ten years (p=0.0005) and as expected, patients with longer follow-up have higher SLICC scores.


SLE damage reflects age of SLE onset diagnosis and disease duration.

To cite this abstract, please use the following information:
Ghanim, Nayef Al, Su, Jiandong, Aghdassi, Ellie, Lou, Wendy, Fortin, Paul R.; The Influence of Age of Onset of Systemic Lupus Erythematosus and Disease Duration on Lupus Manifestations. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2303

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