Systemic lupus erythematosus in three ethnic groups: III A comparison of characteristics early in the natural history of the LUMINA cohort

Aim: To determine and contrast the socioeconomic-demographic and clinical f eatures of patients with recent onset (less than or equal to 5 y) systemic lupus erythematosus (SLE) from three ethnic groups, Hispanic, African-Ameri can and Caucasian (H, AA, C). Subjects and methods: SLE cases (American College of Rheumatology criteria) (incident (n = 56), prevalent (n = 173)), were enrolled in a longitudinal study at The University of Alabama at Birmingham, The University of Texas-H ouston Health Science Center and The University of Texas Medical Branch at Galveston. Socioeconomic-demographic, clinical, immunological, behavioral a nd psychological data were obtained using validated instruments and standar d laboratory techniques, and compared. Results: 70 H, 88 AA and 71 C SLE patients constitute this cohort. H and AA patients were younger and of lower sacioeconomic-demographic status. They also had evidence of more frequent organ system involvement (renal, cardiov ascular), more auto-antibodies, more active disease (after adjusting for di screpant socioeconomic-demographic features), lower levels of social suppor t and more abnormal illness-related behaviors (more in H than in AA). H als o were more likely to have an abrupt disease onset; C were more likely to b e on antimalarials but less likely to be on corticasteroids. H, AA, and C u sed health care resources comparably. They had similar levels of pain and p hysical and mental functioning after adjusting for age, disease duration, i ncome, education, social support, illness-related behaviors, and Systemic L upus Activity Measure or SLAM scores. Conclusions: H and AA patients have more active SLE, at an earlier age of o nset, and a less favorable socioeconomic-demographic structure (worse among the H than AA) which predispose them to a less favorable natural history.