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Longitudinal comparison of treat-to-target states and clinical outcomes in patients with late-onset versus early-onset systemic lupus erythematosus

Worawit Louthrenoo, Alberta Hoi, Vera Golder, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Yeong-Jian Jan Wu, Sandra V. Navarra, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Yanjie Hao, Zhuoli Zhang, B.M.D.B. Basnayake, Madelynn Chan, Jun Kikuchi, Yuko Kaneko, Tsutomu Takeuchi, Shereen Oon, Sang-Cheol Bae, Kristine (Pek Ling) Ng, Sean O’Neill, Geraldine Hassett, Fiona Goldblatt, Tze-Chin Tan, Nicola Tugnet, Cherica Tee, Michael Tee, Mark Sapsford, Chiu Wai Shirley Chan, Chak Sing Lau, Naoaki Ohkubo, Yusuke Miyazaki, Yoshiya Tanaka, Mandana Nikpour, Eric F. Morand, Rangi Kandane-Rathnayake

The Journal of Rheumatology · 2026

Vollständiger Abstract

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Objective We compared demographic and clinical characteristics between patients with late-onset (LO) and early-onset (EO) systemic lupus erythematosus (SLE) and examined their longitudinal associations with treatment targets and long-term outcomes, irreversible organ damage accrual and health-related quality of life (HRQoL). Methods We analyzed prospectively collected data from patients enrolled in the Asia Pacific Lupus Collaboration cohort. Patients diagnosed with SLE at age >50 years were classified as LO-SLE and compared with those diagnosed at age ≤50 years (EO-SLE). Longitudinal associations with treatment targets (LLDAS and DORIS remission), organ damage accrual (SLICC/ACR Damage Index), and HRQoL (SF36v2 physical and mental component summary (PCS and MCS) scores) were examined using multivariable multilevel logistic, recurrent-event survival, and linear mixed-effects models, respectively. Disease activity, flares, medication exposure, and other clinical characteristics were also compared between groups. Results Among 3,917 patients studied, 346 (8.8%) had LO-SLE. Compared with EO-SLE, patients with LO-SLE had lower disease activity, lower glucocorticoid and immunosuppressant exposure, and higher attainment of treatment targets; LO-SLE was associated with higher odds of attaining LLDAS (OR: 2.33 (1.66, 3.28)) and DORIS remission (OR: 2.22 (1.45, 3.38)). However, they were at a greater risk of damage accrual (HR:1.82 (1.50, 2.21)) and lower PCS scores, meaning poorer physical health (regression coefficient (RC) = -3.63 (-4.58, -2.68)) but not MCS (RC= 0.68 (-.50, 1.86)). Conclusion Despite higher attainment of treatment targets, patients with LO-SLE experienced greater damage accrual and poorer physical health, suggesting that disease activity targets alone may not fully capture outcome risk in LO-SLE.

Bibliografischer Nachweis

Publikationsdaten

Autor:innen
Worawit Louthrenoo, Alberta Hoi, Vera Golder, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Yeong-Jian Jan Wu, Sandra V. Navarra, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Yanjie Hao, Zhuoli Zhang, B.M.D.B. Basnayake, Madelynn Chan, Jun Kikuchi, Yuko Kaneko, Tsutomu Takeuchi, Shereen Oon, Sang-Cheol Bae, Kristine (Pek Ling) Ng, Sean O’Neill, Geraldine Hassett, Fiona Goldblatt, Tze-Chin Tan, Nicola Tugnet, Cherica Tee, Michael Tee, Mark Sapsford, Chiu Wai Shirley Chan, Chak Sing Lau, Naoaki Ohkubo, Yusuke Miyazaki, Yoshiya Tanaka, Mandana Nikpour, Eric F. Morand, Rangi Kandane-Rathnayake
Quelle
The Journal of Rheumatology
Publikation
2026-01-01
Band / Ausgabe
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Seiten
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ISSN / ISBN
0315-162X, 1499-2752, 0315-162X
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Worawit Louthrenoo, Alberta Hoi, Vera Golder, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Yeong-Jian Jan Wu, Sandra V. Navarra, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Yanjie Hao, Zhuoli Zhang, B.M.D.B. Basnayake, Madelynn Chan, Jun Kikuchi, Yuko Kaneko, Tsutomu Takeuchi, Shereen Oon, Sang-Cheol Bae, Kristine (Pek Ling) Ng, Sean O’Neill, Geraldine Hassett, Fiona Goldblatt, Tze-Chin Tan, Nicola Tugnet, Cherica Tee, Michael Tee, Mark Sapsford, Chiu Wai Shirley Chan, Chak Sing Lau, Naoaki Ohkubo, Yusuke Miyazaki, Yoshiya Tanaka, Mandana Nikpour, Eric F. Morand, Rangi Kandane-Rathnayake (2026). Longitudinal comparison of treat-to-target states and clinical outcomes in patients with late-onset versus early-onset systemic lupus erythematosus. The Journal of Rheumatology. https://doi.org/10.3899/jrheum.2026-0047
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