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Lupus
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Systemic lupus erythematosus in three ethnic groups: III A comparison of characteristics early in the natural history of the LUMINA cohort

G S Alarcón

Department of Medicine (Division of Clinical Immunology and Rheumatology); Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama; 615 Medical Education Building, 1813 6th Avenue South, The University of Alabama at Birmingham, Birmingham, Alabama 35294. graciela.alarcon{at}ccc.uab.edu

A W Friedman

Department of Medicine (Division of Rheumatology and Clinical Immunogenetics), The University of Texas-Houston Health Science Center, Houston, Texas

K V Straaton

Department of Medicine (Division of Clinical Immunology and Rheumatology); Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama

J M Moulds

J Lisse

Department of Medicine (Division of Rheumatology), The University of Texas, Medical Branch at Galveston, Galveston, Texas

H M Bastian

Department of Medicine (Division of Clinical Immunology and Rheumatology); Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama

G McGwin, Jr.

Department of Medicine Epidemiology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama

A A Bartolucci

Department of Medicine Biostatistics; Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama

J M Roseman

Department of Medicine Epidemiology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama

J D Reveille

Department of Medicine (Division of Rheumatology and Clinical Immunogenetics), The University of Texas-Houston Health Science Center, Houston, Texas

Aim: To determine and contrast the socioeconomic-demographic and clinical features of patients with recent onset (5 y) systemic lupus erythematosus (SLE) from three ethnic groups, Hispanic, African-American and Caucasian (H, AA, C).

Subjects and methods: SLE cases (American College of Rheumatology criteria) (incident (n ‘ 56), prevalent (n ‘ 173)), were enrolled in a longitudinal study at The University of Alabama at Birmingham, The University of Texas-Houston Health Science Center and The University of Texas Medical Branch at Galveston. Socioeconomic-demographic, clinical, immunological, behavioral and psychological data were obtained using validated instruments and standard laboratory techniques, and compared.

Results: 70 H, 88 AA and 71 C SLE patients constitutethis cohort. H and AA patients were younger and of lower socioeconomic-demographic status. They also had evidence of more frequent organ system involvement (renal, cardiovascular), more auto-antibodies, more active disease (after adjusting for discrepant socioeconomic-demographic features), lower levels of social support and more abnormal illness-related behaviors (more in H than in AA). H also were more likely to have an abrupt disease onset; C were more likely to be on antimalarials but less likely to be on corticosteroids. H, AA, and C used health care resources comparably. They had similar levels of pain and physical and mental functioning after adjusting for age, disease duration, income, education, social support, illness-related behaviors, and Systemic Lupus Activity Measure or SLAM scores.

Conclusions: H and AA patients have more active SLE, at an earlier age of onset, and a less favorable socioeconomic-demographic structure (worse among the H than AA) which predispose them to a less favorable natural history.

Key Words: lupus • outcome • socioeconomic • African-American • Hispanic • Caucasian

Lupus, Vol. 8, No. 3, 197-209 (1999)
DOI: 10.1191/096120399678847704
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