AB0636 Late-onset systemic lupus erythematosus: Clinical features, course and prognosis. (23rd January 2014)

• Record Type: Journal Article
• Authors: Tomic Lucic, A.; Petrovic, R.; Radak Perovic, M.; Milovanovic, D.; Veselinovic, M.; Zivanovic, S.; Petrovic, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 71(2012)Supplement 3
• Page Start: 675
• Page End: 675
• Publication Date: 2014-01-23
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2012-eular.636
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: There are contradictory opinions if late-onset systemic lupus erythematosus (SLE) is associated with a different, more benign disease course and better prognosis than early-onset SLE. Objectives: The objective of study was to evaluate the clinical manifestations, course, treatment and prognosis of late-onset SLE. Methods: Patients who developed SLE after/or at the age of 50 years were considered late-onset SLE and compared to a group of randomly selected patients aged younger than 50 years at the diagnosis, matched for disease duration. Results: Lower frequency of cutaneous manifestations (p=0.01) and higher frequency of cytopenia (p=0.02) was registrated at the SLE onset in late-onset group. Atypical clinical presentation of SLE contributed to a longer delay of diagnosis in late-onset patients (p=0.005), who fullfiled less American College of Rheumatology crteria at the diagnosis (p=0.022). Cumulative incidence of clinical manifestations showed lower frequency of cutaneous (p=0.017), neuropsychiatric manifestations(p=0.021), lupus nephritis (p=0.006) and higher frequency of Sjogren$′ $s syndrome (p=0.025) in late-onset group. Late-onset patients received lower corticosteroid (p=0.006) and cyclophosphamide doses (p=0.001), and had more cyclophosphamide induced complications (p=0.005). Higher prevalence of comorbid conditions was noticed in late-onset group. (p<0.0005). Conclusions: Despite the less maior organ involvement, and more benign course of disease, late-onset SLE has worse prognosis, because of the higher frequency of comorbid conditions, due to the aging and longer exposition to a classical vascular risk factors. References: Boddaert J., Huong DL, Amoura Z, Wechsler B, Godeau P, Piette JC. Late-onset systemic lupus erythematosus: a personal series of 47 patients and pooled analysis of 714 cases in literature. Medicine (Baltimore) 2004; 83: 348-59. Appenzeller S., Pereira DA, Costallat LT. Greater accrual damage in late-onset systemic lupus erythematosus: long-term follow –up study. Lupus 2008; 17(11): 1023-8. Lalani S, Pope J, de Leon F, Peschen C. Clinical features and prognosis of late onset systemic lupus erythematosus: results from the 1000 faces of lupus study. J Rheumathol 2010; 37(1):38-44. Rovensky J, Tuchynova A. Systemic lupus erythematosus in the elderly. Autoimmunity Rev 2008; 7: 235-9. Bertoli AM, Alacron GS, Calvo-Alen J, Fernandez M, Vila LM, Reveille JD. LUMINA Study Group. systemic lupus etrythematosus in multietnic US cohort. XXXIII. Clinical features, course and outcome in patients with late-onset disease. Arthritis Rheum 2006; 54 (5): 1580-7. Disclosure of Interest: None Declared