The 1000 Canadian faces of lupus: Influence of ethnicity on disease in the pediatric cohort
Arthritis Care & Research , 06/29/2012
Levy DM et al. – Canadian Childhood–onset SLE (cSLE) patients reflect the multi–ethnic population, with differences in disease manifestations, autoantibody profiles and severity of disease expression by ethnicity.Methods
- Childhood–onset SLE (cSLE) patients at four pediatric centers in Halifax, Montreal, Toronto and Vancouver were consecutively recruited.
- Sociodemographics and disease data were collected.
- Patients were categorized by their primary self–selected ethnicity, and exploratory cluster analyses were examined for disease expression by ethnicity.
- The authors enrolled 213 cSLE patients, and ethnicity data were available for 206 patients: White (31%), Asian (30%), South Asian (15%), Black (10%), Latino/Hispanic (4%), Aboriginal (4%) and Arab/Middle Eastern (3%).
- The frequency of clinical classification criteria (malar rash, arthritis, serositis and renal disease) and autoantibodies significantly differed among ethnicities.
- Medications were prescribed equally across ethnicities: 76% were taking prednisone, 86% anti–malarials, and 56% required additional immunosuppressants.
- Cluster analysis partitioned three main groups – mild (N = 50), moderate (N = 82) and severe (N = 68) disease clusters.
- Only 20% of White patients were in the severe cluster compared to 51% of Asian and 41% of Black patients (p=0.03).
- However, disease activity indices and damage scores were similar across ethnicities.