Lupus & antiphospholipid syndrome
Item-specific factors associated with damage accrual in systemic lupus erythematosus: insights from a multiethnic, multinational Latin American cohort
Authors' conclusion
Factors associated with damage accrual differ substantially by individual SDI items. Mestizo ethnicity and recent disease activity increased renal risks, while antimalarials were protective. GCs showed mixed effects.
Study context
- Population
- Patients from the Latin American SLE incident cohort (GLADEL)
- Participants
- 1,385 patients
- Outcome
- Damage accrual, defined as a SLICC/ACR DI (SDI) change in any individual item during follow-up (SDI assessed yearly)
Methodological detailsmultiethnic, multinational, incident cohort, multivariate Cox proportional hazard models with time-varying hazard risk effect
- Multiethnic
- Multinational
- Incident cohort
- Multivariate Cox proportional hazard models with time-varying hazard risk effect
Main finding
As reported in the abstract
New damage accrual (overall) · median 54 months (p25-75: 29-71) of follow-up
Patients accruing new damage
658
48%
Observational data: associations, not effects.
Further findings
Scarring chronic alopecia · 7 years follow-up
- Cumulative frequency
- 23.7%
- Protectors: older age, longer disease duration, diagnostic delay, SDI >0 and cytotoxic use
Proteinuria >3.5 g/24 hours · 7 years follow-up
- Cumulative frequency
- 11.5%
- Protective: older age, longer disease duration and higher GC dose
- Risk factors: Mestizo ethnicity, low medical coverage, higher SLE Disease Activity Index (SLEDAI) scores and cytotoxic use
eGFR <50% and end-stage renal disease (ESRD)
- Mestizo ethnicity a risk factor for eGFR <50% and ESRD; antimalarial protected from ESRD
Pericarditis, retinal change or optic atrophy
- Glucocorticoids (GCs) were risk factors
Additional SDI items
- Recent disease activity and cytotoxic use significant risk factors
Original publication
Item-specific factors associated with damage accrual in systemic lupus erythematosus: insights from a multiethnic, multinational Latin American cohort. Lupus Sci Med. Published 30 July 2025. doi:10.
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