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Impact of age at disease onset on clinical manifestations and prognosis in systemic lupus erythematosus
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Impact of age at disease onset on clinical manifestations and prognosis in systemic lupus erythematosus
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Impact of age at disease onset on clinical manifestations and prognosis in systemic lupus erythematosus
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Journal Article
Impact of age at disease onset on clinical manifestations and prognosis in systemic lupus erythematosus
2025
Overview
Objective: To assess age-related differences in demographic, clinical, and treatment characteristics of systemic lupus erythematosus (SLE) patients and evaluate outcomes based on age at disease onset. Methods: Patients diagnosed with SLE who met 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were retrospectively evaluated. Patients were classified based on age at onset: adult-onset (18-49 years) and late-onset (≥50 years). Demographic, clinical, laboratory characteristics and outcomes of adult and late-onset groups were compared. Disease damage was evaluated with the SLICC/American College of Rheumatology damage index (SDI). To assess the effect of age on mortality, Cox regression analysis was performed with the selected variables that were causally associated with the outcome. Results: Among 519 patients, 88.1% were female, with a mean diagnosis age of 36.6 years. Adult-onset SLE represented 82.3% of cases, while 17.7% had late-onset disease. Neurological involvement was more frequent in adult-onset SLE (25.8% vs. 16.3%), as was renal involvement (41.1% vs. 26.1%). Anti-ribonucleoprotein antibodies were more prevalent in adult-onset SLE (24.7% vs. 7.1%, p<0.001). Damage accrual was observed in 40.3% of patients, without significant differences in SDI scores between groups. After a median follow-up of 9.2 years, 10.8% of patients died, with a higher mortality rate in late-onset SLE (20.7% vs. 8.7%, p=0.001). Cox regression showed age at SLE onset was independently associated with increased mortality (hazard ratio: 1.09, 95% confidence interval: 1.06-1.11, p<0.001). Conclusion: Age at SLE onset is associated with distinct clinical features and outcomes. Late-onset SLE patients experience higher mortality, emphasizing the need for age-specific approaches in SLE management.
Publisher
Turkish Society for Rheumatology
Subject
