Clinical research studyLong-Term Prognosis and Causes of Death in Systemic Lupus Erythematosus
Section snippets
Patients and methods
We recruited 207 consecutive patients with an SLE diagnosis who were seen at the Division of Rheumatology, Padua University, during a 40-year period. A total of 181 patients were female and 26 were male (female:male ratio 7:1). The mean (±standard deviation) age at diagnosis was 32.3 ± 9 years.
All patients satisfied at least four of the American College of Rheumatology (ACR) criteria for the Classification of SLE15 and were managed according to diagnostic and therapeutic guidelines similar to
Results
The main clinical manifestations and laboratory abnormalities of 207 patients are summarized in Table 1. Ninety-two patients (44.4 %) had severe SLE, and 115 patients (55.6 %) had mild SLE. At the time of baseline evaluation, the patients had an average European Consensus Lupus Activity Measure score of 3.32 ± 1.26 (range 1-8), and 21 patients (10%) had damage in at least one of the organ systems considered in the Systemic Lupus International Collaborating Clinic and ACR Damage Index.
Discussion
Our study was performed on a cohort of 207 patients followed up for a long period of time. All of the patients satisfied the ACR criteria15 for SLE classification and were managed according to a protocol similar to that recently developed by the ACR.13
The mortality we observed in this cohort was similar to that reported in the most recent studies in which it varied from 6.8% to 20.2% in SLE cohorts followed up for periods ranging from 8 to 14 years.3, 23, 24, 25 The survival rates at 5, 10, and
Conclusion
Our study confirms the increase of short- and medium-term survival in patients with SLE. The drugs used for the treatment of the severe manifestations of SLE, particularly glomerulonephritis, seem to reduce the overall mortality caused by disease activity during the first 10 to 15 years after the diagnosis, but, unfortunately, they may induce severe side effects leading to a poor long-term prognosis.
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