Association between clinical factors, socioeconomic status, and organ damage in recent onset systemic lupus erythematosus

Objective. To determine the prevalence and socioeconomic and clinical predi ctors of early organ damage in a cohort of patients with systemic lupus ery thematosus (SLE) of 2-7 years' duration randomly sampled at 5 centers and b alanced by socioeconomic status and race. Methods. The Systemic Lupus international Collaborating Clinics/American Co llege of Rheumatology (SLICC/ACR) Damage Index was measured in 200 patients who met the ACR criteria for SLE with a mean disease duration of 3.8 years . The SLICC/ACR scores for each organ system and the prevalence of damage w ithin organ systems were assessed. Logistic regression analyses evaluated t he simultaneous effects of age at diagnosis, disease duration, disease acti vity, and sociodemographic factors. Results. Sixty-one percent of the patients had damage within 7 years of ons et (mean 3.8 yrs). Neuropsychiatric (20.5%) and musculoskeletal (18.5%) sys tems were the most frequently involved, followed by renal (15.5%) and skin (12.5%) systems, all with median SLICC/ACR organ system scores of 1. In mul tivariate models, African-American race was associated with skin damage but nor with damage in other specific organ systems. Socioeconomic status was not associated with organ system damage. Older age at diagnosis correlated with cardiovascular, musculoskeletal, gastrointestinal, ocular, and pulmona ry damage. Clinical factors such as longer disease duration correlated with higher renal and cardiovascular damage, and greater disease activity at di agnosis of SLE correlated with greater renal, musculoskeletal, and pulmonar y damage. Conclusion. There is evidence of organ system damage in SLE within a mean o f 3.8 years after onset. We found little evidence for differences in early organ damage according to race or socioeconomic status. Damage to most orga n systems was related to age at diagnosis of SLE and clinical factors such as disease duration.