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10-05-2022 | Rheumatology | News | Article

CLUES study highlights racial disparities in end-organ lupus manifestations

Author: Laura Cowen

medwireNews: Hispanic and Asian people with systemic lupus erythematosus (SLE) are at significantly greater risk for developing renal, hematologic, and multiorgan disease than their White counterparts, US study findings indicate.

Furthermore, “[r]enal and hematologic disease tended to occur in early SLE, with faster time to onset among Hispanic and Asian patients,” write Alfredo Aguirre (University of California, San Francisco) and co-authors in Arthritis Care & Research.

Their longitudinal California Lupus Epidemiology Study (CLUES) included 326 participants (mean age 45 years, 89% women) with SLE (mean duration 16 years). The cohort was racially and ethnically diverse, with 36% self-reporting as Asian, 30% White, 23% Hispanic, and 11% Black.

The researchers report that, by organ system, musculoskeletal (81%) and mucocutaneous (76%) manifestations were most common.

Renal disease (51%) was the most common end-organ manifestation, followed by hematologic (20%), neurologic (20%), cardiovascular (13%), and pulmonary (6%) disease, with median times to onset ranging from 0 years for hematologic manifestations to 16 years for cardiovascular disease.

Multiorgan disease was present in 29% of participants, of whom 74% had two organ systems involved, 24% had three, and 2% had four.

Adjusted analyses showed that Hispanic participants had a significantly higher risk for renal, hematologic, and multiorgan disease following SLE diagnosis than White participants, at hazard ratios (HRs) of 2.93, 2.72, and 3.28, respectively.

There was a similar pattern of elevated risk for Asian participants, with corresponding HRs of 2.92, 2.07, and 2.51.

Aguirre and team also found that time to onset of multiorgan disease, as well as renal and hematologic disease, was significantly shorter for Hispanic and Asian participants than it was for White participants.

The investigators note that there were no significant associations between race and ethnicity and neurologic or cardiovascular disease outcomes and no significant difference in outcomes between Black and White participants. However, this latter observation may be explained by the small number of Black people enrolled in the study, they say.

Aguirre et al conclude that their “study sheds light on interesting temporal trends in SLE disease trajectories” and “in particular highlights the burden of multiorgan involvement in Hispanic and Asian participants, which warrants further study to delineate the health impacts of severe, multiorgan SLE in these populations.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

Arthritis Care Res 2022; doi:10.1002/acr.24892

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