SLICC ACR DAMAGE INDEX IN AFRO-CARIBBEAN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS - CHANGES IN AND RELATIONSHIP TO DISEASE-ACTIVITY, CORTICOSTEROID-THERAPY, AND PROGNOSIS/

Objective, To apply the recently described Systemic Lupus Internationa l Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) in a well defined cohort of patients with systemic lupu s erythematosus (SLE) and to study its association with disease activi ty, corticosteroid therapy, and prognosis. Methods. We conducted a rec ord review of 90 patients with SLE followed at a single center for a m ean period of 6 years with periodic evaluations of SLE Disease Activit y Index (SLEDAI), cumulative damage according to SLICC/ACR-DI, and the rapy. Overall disease activity during the disease course was calculate d as weighted averages of SLEDAI (WAS). Results, Mean SLICC/ACR-DI was 0.6 six months after diagnosis and increased to 2.4 at last assessmen t. Thirteen patients (14%) remained free of accumulated damage at last visit. Index scores showed significant correlations with WAS scores a nd the number of disease exacerbations (SLEDAI > 10), but not with age , mean daily, or cumulative corticosteroid dosage. High WAS scores wer e independently associated with poorer survival, but SLICC/ACR-DI scor es were not. Conclusion, SLICC/ACR-DI scores correlate with overall di sease activity, but not with length or intensity of corticosteroid the rapy. While easily applicable, its prognostic value is subordinate to that of persistent disease activity.