Differences in clinical manifestations and increased severity of systemic lupus erythematosus between two groups of Hispanics: European Caucasians versus Latin American mestizos (data from the RELESSER registry).
Por:
Cruz, B, Alonso, F, Alen, J, Pego-Reigosa, J, Lopez-Longo, F, Galindo-Izquierdo, M, Olive, A, Tomero, E, Horcada, L, Uriarte, E, Erausquin, C, Sanchez-Atrio, A, Montilla, C, Soler, G, Fernandez-Nebro, A, Blanco, R, Rodriguez-Gomez, M, Vela C, Freire, M, Diez-Alvarez, E, Boteanu, A, Narvaez, J, Taboada, V, Ruiz-Lucea, E, Andreu, J, Fernandez-Berrizbeitia, O, Hernandez-Beriain, J, Gantes, M, Perez-Venegas, J, Ibanez-Barcelo, M, Pecondon-Espanol, A, Marras, C, Bonilla, G, Castellvi, I, Moreno, M, Raya, E, Vila, V, Vazquez, T, Ruan, J, Munoz, S and Rua-Figueroa, I
Publicada:
1 ene 2020
Ahead of Print:
4 dic 2019
Categoría:
Rheumatology
Resumen:
BACKGROUND: Systemic lupus erythematosus (SLE) is regarded as a prototype autoimmune disease because it can serve as a means for studying differences between ethnic minorities and sex. Traditionally, all Hispanics have been bracketed within the same ethnic group, but there are differences between Hispanics from Spain and those from Latin America, not to mention other Spanish-speaking populations. OBJECTIVES: This study aimed to determine the demographic and clinical characteristics, severity, activity, damage, mortality and co-morbidity of SLE in Hispanics belonging to the two ethnic groups resident in Spain, and to identify any differences. METHODS: This was an observational, multi-centre, retrospective study. The demographic and clinical variables of patients with SLE from 45 rheumatology units were collected. The study was conducted in accordance with Good Clinical Practice guidelines. Hispanic patients from the registry were divided into two groups: Spaniards or European Caucasians (EC) and Latin American mestizos (LAM). Comparative univariate and multivariate statistical analyses were carried out. RESULTS: A total of 3490 SLE patients were included, 90% of whom were female; 3305 (92%) EC and 185 (5%) LAM. LAM patients experienced their first lupus symptoms four years earlier than EC patients and were diagnosed and included in the registry younger, and their SLE was of a shorter duration. The time in months from the first SLE symptoms to diagnosis was longer in EC patients, as were the follow-up periods. LAM patients exhibited higher prevalence rates of myositis, haemolytic anaemia and nephritis, but there were no differences in histological type or serositis. Anti-Sm, anti-Ro and anti-RNP antibodies were more frequently found in LAM patients. LAM patients also had higher levels of disease activity, severity and hospital admissions. However, there were no differences in damage index, mortality or co-morbidity index. In the multivariate analysis, after adjusting for confounders, in several models the odds ratio (95% confidence interval) for a Katz severity index >3 in LAM patients was 1.45 (1.038-2.026; p = 0.02). This difference did not extend to activity levels (i.e. SLEDAI >3; 0.98 (0.30-1.66)). CONCLUSION: SLE in Hispanic EC patients showed clinical differences compared to Hispanic LAM patients. The latter more frequently suffered nephritis and higher severity indices. This study shows that where lupus is concerned, not all Hispanics are equal.
Filiaciones:
Cruz, B:
Virgen Macarena Univ Hosp, Dept Rheumatol, Seville, Spain
Alonso, F:
Spanish Soc Rheumatol, Res Unit, Madrid, Spain
Alen, J:
Araba Univ Hosp, Dept Rheumatol, Vitoria, Spain
Pego-Reigosa, J:
Inst Invest Biomed Vigo, Univ Hosp Complex, Dept Rheumatol, Vigo, Spain
Lopez-Longo, F:
Gregorio Maranon Univ Hosp, Dept Rheumatol, Madrid, Spain
Galindo-Izquierdo, M:
12th October Univ Hosp, Dept Rheumatol, Madrid, Spain
Olive, A:
Germans Trias & Pujol Univ Hosp, Dept Rheumatol, Badalona, Spain
Tomero, E:
La Princesa Univ Hosp, Dept Rheumatol, Madrid, Spain
Horcada, L:
Navarra Hosp, Dept Rheumatol, Navarra, Spain
Uriarte, E:
Donosti Hosp, Dept Rheumatol, Guipuzcoa, Spain
Erausquin, C:
Dr Negrin Univ Hosp, Dept Rheumatol, Las Palmas Gran Canaria, Spain
Sanchez-Atrio, A:
Principe Asturias Univ Hosp, Dept Rheumatol, Madrid, Spain
Montilla, C:
Salamanca Clin Univ Hosp, Dept Rheumatol, Salamanca, Spain
:
Marina Baixa Hosp, Dept Rheumatol, Alicante, Spain
Fernandez-Nebro, A:
Carlos Haya Univ Hosp, Dept Rheumatol, Malaga, Spain
Blanco, R:
Marques de Valdecilla Univ Hosp, Dept Rheumatol, Santander, Spain
Rodriguez-Gomez, M:
Hosp Complex Ourense, Dept Rheumatol, Orense, Spain
Vela C:
Alicante Gen Hosp, Dept Rheumatol, Alicante, Spain
Freire, M:
Hosp Juan Canalejo, Dept Rheumatol, La Coruna, Spain
Diez-Alvarez, E:
Leon Hosp, Dept Rheumatol, Leon, Spain
Boteanu, A:
Ramon & Cajal Univ Hosp, Dept Rheumatol, Madrid, Spain
Narvaez, J:
Bellvitge Hosp, Dept Rheumatol, Barcelona, Spain
Taboada, V:
Marques de Valdecilla Univ Hosp, Dept Rheumatol, Santander, Spain
Ruiz-Lucea, E:
Basurto Hosp, Dept Rheumatol, Bilbao, Spain
Andreu, J:
Puerta del Hierro Majadahonda Hosp, Dept Rheumatol, Madrid, Spain
Fernandez-Berrizbeitia, O:
Basurto Hosp, Dept Rheumatol, Basurto, Spain
Hernandez-Beriain, J:
Hosp Insular Gran Canaria, Dept Rheumatol, Gran Canaria, Spain
Gantes, M:
Tenerife Clin Hosp, Dept Rheumatol, Tenerife, Spain
Perez-Venegas, J:
Jerez de la Frontera Univ Hosp, Dept Rheumatol, Cadiz, Spain
Ibanez-Barcelo, M:
Son Llatzer Hosp, Dept Rheumatol, Mallorca, Spain
Pecondon-Espanol, A:
Miguel Servet Univ Hosp, Dept Rheumatol, Zaragoza, Spain
Marras, C:
Virgen de la Arrixaca Univ Hosp, Dept Rheumatol, Murcia, Spain
Bonilla, G:
La Paz Univ Hosp, Dept Rheumatol, Madrid, Spain
Castellvi, I:
Alt Penedes Dist Hosp, Rheumatol Unit, Barcelona, Spain
Moreno, M:
Parc Tauli Hosp, Dept Rheumatol, Barcelona, Spain
Raya, E:
San Cecilio Hosp, Dept Rheumatol, Granada, Spain
Vila, V:
Monforte Hosp, Rheumatol Unit, Lugo, Spain
Vazquez, T:
Lucus Augusti Hosp, Dept Rheumatol, Lugo, Spain
Ruan, J:
POVISA Med Ctr, Rheumatol Unit, Vigo, Spain
Munoz, S:
Infanta Sofia Univ Hosp, Rheumatol Serv, Madrid, Spain
Rua-Figueroa, I:
Doctor Negrin Univ Hosp Gran Canaria, Dept Rheumatol, Las Palmas Gran Canaria, Spain
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