Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus

• DOI: 10.1177/0961203310366572
• Publication Date: 2010-04-08T01:09:06Z
• Authors: J. Nossent; E. Kiss; B. Rozman; G. Pokorny; P. Vlachoyiannopo...; M. Olesinska; A. Marchesoni; M. Mosca; S. Påi; K. Manger; M. Schneider; H. Nielsen; R. van Vollenhoven; T. Swaak
• Keywords: Malar rash; Leukocytopenia

An inception cohort of patients with systemic lupus erythematosus from 14 European centres was followed for up to 5 years in order describe the current early disease course. At inclusion (n = 200, 89% female, mean age 35 years, 97% Caucasian, SLEDAI 12.2) fulfilled a 6.5 ACR classification criteria. The most prevalent criteria were antinuclear Ab presence (97%) by anti-dsDNA (74%), arthritis (69%), leukocytopenia (54%) and malar rash (53%), antiphospholipid (48%) anti-synovial membrane (21.6%). Clinical signs nephritis (LN) present 39% biopsy-confirmed LN seen 25%. Frequent additional findings hypocomplementaemia (54%), anti-SSA (49%), alopecia (26%) Raynaud's phenomenon (31%). There few regional differences presentation management. One 5-year survival rates 99% respectively. During follow-up 4.1 25% entered state quiescence global physician assessment, but overall risk subsequent flare 60%. Maximum scores decreased over time, 45% accrued damage (SDI >or=1) which baseline proteinuria persistent activity independent predictors. results indicate minor SLE treatment within various regions Europe high diagnostic reliance on Ab. Despite reductions improved mortality, development is, however, still substantial, especially not entering an remission.