Systemic lupus erythematosus: clinical features in patients with a diseaseduration of over 10 years, first evaluation

Objective. Most information available about the disease course of patients with systemic lupus erythematosus (SLE) is restricted to the first 5 yr aft er disease onset. Data about the disease course 10 yr after disease onset a re rare. The aim of this multicentre study was to describe the outcome of S LE patients with a disease duration of >10 yr. Methods. Outcome parameters were the SLE Disease Activity Index (SLEDAI); t he European Consensus Lupus Activity Measure (ECLAM), the Systemic Lupus In ternational Collaborative Clinics/American College of Rheumatology Damage I ndex (SLICC/ACR), a global damage index (DI) and required treatment. In 10 different European rheumatology centres, all SLE patients who were evaluate d in the last 3 months of 1994, and who had been diagnosed with SLE at leas t 10 yr ago, were included in the study. Results. It should be stressed that our results are confined to a patient c ohort, defined by a disease duration of at least 10 yr, and who are still u nder clinical care at the different centres in Europe. These SLE patients s till showed some disease activity, related to symptoms of the sl;in and mus culoskeletal systems, next to the presence of renal involvement. A total of 72% of the patients needed treatment with prednisolone (less than or equal to 7.5 mg). The cumulative damage was overall related to clinical features of the central nervous system (14%) and renal involvement (14%), next to d eforming arthritis (14%), osteoporosis (15%) and hypertension (40%). The pr evalences of obesity, Gushing appearance and diabetes are highly suggestive that the ongoing treatment and that in the past might have had an impact o n the total sum of endorgan damage. Conclusions. After 10 yr, a high proportion of patients in our cohort conti nued to show evidence of active disease, defined by the SLEDAI as well as E CLAM. The DI was related to the involvement of the central nervous system, renal involvement and the presence of hypertension.