Childhood-onset systemic lupus erythematosus: A descriptive and comparative study of clinical, laboratory, and treatment characteristics in two populations.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2024-09-01 Epub Date: 2024-07-22 DOI:10.1177/09612033241265975
Gülşah Kavrul Kayaalp, Deren Esencan, Vafa Guliyeva, Selen Duygu Arık, Şeyma Türkmen, Sezgin Şahin, Yelda Bilginer, Özgür Kasapçopur, Betül Sözeri, Seza Özen, Nuray Aktay Ayaz, Amr H Sawalha
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引用次数: 0

Abstract

Objective: The aim of this study was to characterize childhood-onset systemic lupus erythematosus (SLE) in two large cohorts from Turkey and the United States.

Methods: Patients diagnosed with childhood-onset SLE who fulfilled the 1997 American College of Rheumatology classification criteria for SLE from four reference centers in Turkey and the University of Pittsburgh School of Medicine in the United States were included in this study. A comparative analysis was conducted to evaluate the similarities and differences in clinical and laboratory features, damage accrual, and treatment experiences between the two populations.

Results: A total of 174 patients with childhood-onset SLE were included in this study (108 patients from Turkey and 66 patients from the United States). The female-to-male ratio was similar between the two cohorts (∼3:1, p = .73). The median age at diagnosis was 11.67 years (2.19-17.93) in the Turkish cohort and 13.68 years (2.74-17.93) in the U.S. cohort (p < .001). Photosensitivity (45.4% and 21.2%; p = .007) and renal involvement (41.7% and 36.4%; p = .045) were higher in the Turkish cohort. Anti-Ro/SSA (34.8% and 15.7%; p < .001), anti-Sm (59.1% and 19.4%; p < .001), and anti-RNP (47.0% and 14.8%; p < .001) positivity was more frequent in the U.S. cohort. Current use of rituximab (37.9% and 1.9%; p < .001) and belimumab (19.7% and 0%; p < .001) was more prevalent in the U.S. cohort, while the use of cyclophosphamide (often according to the low dose Euro-Lupus protocol) throughout the disease course (24.1% and 4.5%; p < .001) was more frequent in the Turkish cohort. SLICC/ACR Damage Index scores were not different between the two cohorts.

Conclusion: This study provides detailed clinical and laboratory features of childhood-onset SLE in two independent and geographically divergent cohorts. Our findings suggest an earlier age of disease onset and a higher prevalence of kidney involvement in Turkish patients. Differences in treatment approaches were also noted. However, damage accrual related to SLE does not appear to be different between the two patient populations.

儿童期发病的系统性红斑狼疮:对两种人群的临床、实验室和治疗特点进行描述性比较研究。
研究目的本研究旨在从土耳其和美国的两个大型队列中了解儿童期发病的系统性红斑狼疮(SLE)的特征:本研究纳入了来自土耳其四个参考中心和美国匹兹堡大学医学院的符合 1997 年美国风湿病学会系统性红斑狼疮分类标准的儿童期系统性红斑狼疮患者。研究人员进行了对比分析,以评估两类人群在临床和实验室特征、损害累积和治疗经验方面的异同:本研究共纳入174名儿童期系统性红斑狼疮患者(108名来自土耳其,66名来自美国)。两组患者的男女比例相似(∼3:1,P = .73)。土耳其队列中诊断年龄的中位数为 11.67 岁(2.19-17.93),美国队列中诊断年龄的中位数为 13.68 岁(2.74-17.93)(p < .001)。土耳其队列中光敏性(45.4% 和 21.2%;p = .007)和肾脏受累(41.7% 和 36.4%;p = .045)的比例更高。抗Ro/SSA(34.8%和15.7%;p < .001)、抗Sm(59.1%和19.4%;p < .001)和抗RNP(47.0%和14.8%;p < .001)阳性在美国队列中更为常见。目前使用利妥昔单抗(37.9% 和 1.9%;p < .001)和贝利木单抗(19.7% 和 0%;p < .001)的情况在美国队列中更为普遍,而在整个病程中使用环磷酰胺(通常根据低剂量欧洲狼疮方案)的情况(24.1% 和 4.5%;p < .001)在土耳其队列中更为普遍。SLICC/ACR损伤指数评分在两个队列中没有差异:本研究提供了两个独立的、地域不同的队列中儿童期发病的系统性红斑狼疮的详细临床和实验室特征。我们的研究结果表明,土耳其患者的发病年龄较早,肾脏受累的患病率较高。治疗方法也存在差异。不过,与系统性红斑狼疮相关的损害累积在这两个患者群体中似乎并无不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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