Multicenter Study of Associations Between Area‐Level Child Opportunity, Initial Disease Severity, and Outcomes Among Children with Lupus
Main finding · Severe initial disease presentationResult — go to the resultAdjusted odds ratio 1.93 95% CI 1.05–3.57Authors' conclusion
Structural inequities in area-level child opportunity may contribute to disparities in both cSLE severity and disease control.
Study context
- Population
- Patients with childhood-onset SLE (cSLE) at three tertiary centres, 2016–2022
- Participants
- 538 patients
- Exposure
- Low vs very high area-level Child Opportunity Index
- Outcome
- Primary outcomes: severe initial disease presentation (composite of SLEDAI-2K ≥10, intensive care, or dialysis) and acute care (inpatient/emergency) visits
Methodological detailsmulticentre, mixed effects models clustered by site, adjusted for age, sex, race and ethnicity, language, and insurance status
- Multicentre
- Mixed effects models clustered by site
- Adjusted for age, sex, race and ethnicity, language, and insurance status
Main finding
Severe initial disease presentation
Adjusted odds ratio
1.93
95% CI 1.05–3.57
Low COIvs Very high COI
aOR 1.93 (95% CI 1.05–3.57)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Concurrent SLEDAI-2K ≤ 4 and ≤7.5 mg/day prednisone · most recent follow-upAdjusted for initial disease severity and disease duration | 0.44 (0.22–0.88) | |
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Primary: acute care visits within the first year (adjusted incidence) | adjusted incidence 2.03 (95% CI 1.29–3.18) |
| Disease activity · most recent follow-up | adjusted β 1.69 (95% CI 0.54–2.84) |
Original publication
Multicenter Study of Associations Between Area‐Level Child Opportunity, Initial Disease Severity, and Outcomes Among Children with Lupus. Arthritis Care Res (Hoboken). Published 14 April 2025. doi:10.
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