Risk factors for damage in childhood‐onset systemic lupus erythematosus: Cumulative disease activity and medication use predict disease damage

作者：Hermine I. Brunner, Earl D. Silverman, Theresa To, Claire Bombardier, Brian Michael Feldman · 发表于：Arthritis & Rheumatism · 年份：2002 · DOI：10.1002/art.10072 · 被引用次数：319 · 研究领域：Systemic Lupus Erythematosus Research、Rheumatoid Arthritis Research and Therapies、Systemic Sclerosis and Related Diseases

OBJECTIVE: The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index measures damage in adult patients with systemic lupus erythematosus (SLE), but its usefulness in patients with childhood-onset SLE has not been examined. This study was conducted to evaluate the sensibility of the SLICC/ACR Damage Index, to investigate how cumulative disease activity is related to damage in childhood-onset SLE, and to identify other risk factors for damage in childhood-onset SLE. METHODS: Disease activity and damage in 66 patients with newly diagnosed childhood-onset SLE were assessed retrospectively, and information on potential risk factors for damage (age, race, sex, medications, duration of disease, hypertension, body mass index, antiphospholipid antibodies, kidney disease, acute thrombocytopenia) was obtained. In addition, a group of physicians was surveyed to establish the sensibility of the SLICC/ACR Damage Index in childhood-onset SLE. RESULTS: The SLICC/ACR Damage Index was found to have face, content, and construct validity when used in children. The mean SLICC/ACR Damage Index score of the patients was 1.76 (mean followup 3.3 years). Cumulative disease activity over time was the single best predictor of damage (R(2) = 0.30). Other, possibly important risk factors for damage were corticosteroid treatment, the presence of antiphospholipid antibodies, and acute thrombocytopenia. It was determined that immunosuppressive agents may...