Time to diagnosis in systemic lupus erythematosus: Associated factors and its impact on damage accrual and mortality. Data from a multi-ethnic, multinational Latin American lupus cohort
Journal
Lupus
ISSN
0961-2033
1477-0962
Date Issued
2024
Author(s)
Romina Nieto
Rosana Quintana
Ernesto Zavala-Flores
Rosa Serrano
Karen Roberts
Luis J Catoggio
Mercedes A García
Guillermo A Berbotto
Verónica Saurit
Eloisa Bonfa
Eduardo F Borba
Lilian T Lavras Costallat
Nilzio A Da Silva
Emilia I Sato
Joao C Tavares Brenol
Loreto Massardo
Gloria Vázquez
Marlene Guibert Toledano
Virginia Pascual-Ramos
María J Sauza del Pozo
Leonor A Barile-Fabris
Mary-Carmen Amigo
Ignacio García De La Torre
Eduardo M Acevedo-Vásquez
María I Segami
Rosa Chacón-Díaz
María H Esteva-Spinetti
Graciela S Alarcón
Bernardo A Pons-Estel
Guillermo J Pons-Estel
Type
journal-article
Abstract
<jats:sec><jats:title>Background</jats:title><jats:p> Systemic lupus erythematosus (SLE) often mimics symptoms of other diseases, and the interval between symptom onset and diagnosis may be long in some of these patients. Aims: To describe the characteristics associated with the time to SLE diagnosis and its impact on damage accrual and mortality in patients with SLE from a Latin American inception cohort. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Patients were from a multi-ethnic, multi-national Latin-American SLE inception cohort. All participating centers had specialized lupus clinics. Socio-demographic, clinical/laboratory, disease activity, damage, and mortality between those with a longer and a shorter time to diagnosis were compared using descriptive statistical tests. Multivariable Cox regression models with damage accrual and mortality as the end points were performed, adjusting for age at SLE diagnosis, gender, ethnicity, level of education, and highest dose of prednisone for damage accrual, plus highest dose of prednisone, baseline SLEDAI, and baseline SDI for mortality. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of the 1437 included in these analyses, the median time to diagnosis was 6.0 months (Q1–Q3 2.4–16.2); in 721 (50.2%) the time to diagnosis was longer than 6 months. Patients whose diagnosis took longer than 6 months were more frequently female, older at diagnosis, of Mestizo ethnicity, not having medical insurance, and having “non-classic” SLE symptoms. Longer time to diagnosis had no impact on either damage accrual (HR 1.09, 95% CI 0.93–1.28, p = 0.300) or mortality (HR 1.37, 95% CI 0.88–2.12, p = 0.200). </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> In this inception cohort, a maximum time of 24 months with a median of 6 months to SLE diagnosis had no apparent negative impact on disease outcomes (damage accrual and mortality). </jats:p></jats:sec>
Cite this document
Nieto, R., Quintana, R., Zavala-Flores, E., Serrano, R., Roberts, K., Catoggio, L. J., García, M. A., Berbotto, G. A., Saurit, V., Bonfa, E., Borba, E. F., Lavras Costallat, L. T., Da Silva, N. A., Sato, E. I., Tavares Brenol, J. C., Massardo, L., Neira, O. J., Vázquez, G., Guibert Toledano, M., … Pons-Estel, G. J. (2024). Time to diagnosis in systemic lupus erythematosus: Associated factors and its impact on damage accrual and mortality. Data from a multi-ethnic, multinational Latin American lupus cohort. Lupus, 33(4), 340-346. https://doi.org/10.1177/09612033241232821
Subjects
systemic lupus erythematosus
;
disease activity
;
damage accrual
;
mortality