Baseline characteristics of patients with SLE with and without lupus nephritis from the Latin American multiethnic GLADEL 2.0 cohort.

OBJECTIVE

To describe baseline characteristics of a multinational, multiethnic Latin American cohort of SLE patients with and without lupus nephritis (LN) from Latin American Group for the Study of Lupus (GLADEL) 2.0.

METHODS

GLADEL 2.0 is an observational prevalent and incident cohort. Adult patients (≥18 years) with SLE who fulfilled the 1982/1997 American College of Rheumatology (ACR) and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria from 43 centres in 10 Latin American countries were categorised into four groups: (1) without LN, (2) prevalent inactive LN, (3) prevalent active LN and (4) incident LN. Baseline demographics, clinical manifestations, treatments, disease activity and damage were recorded. A cross-sectional analysis and logistic regression was conducted to identify factors associated with LN and cumulative damage (SLICC/ACR Damage Index (SDI)).

RESULTS

Among 1083 patients, 89.6% were female, median age at diagnosis was 27 years, median disease duration was 66.2 months and 65.0% were Mestizo. Patients with LN (n=653) were younger and had shorter disease duration than patients without LN. LN was negatively associated with older age at diagnosis (OR, 0.98) and discoid rash (OR, 0.53) and positively associated with male gender (OR, 1.91), Mestizo ethnicity (OR, 1.46), comorbidities (OR, 3.2), thrombocytopenia (OR, 3.44), anti-double-stranded DNA (anti-dsDNA) positivity (OR, 3.23) and low complement (OR, 1.54). SDI ≥1 was associated with older age at diagnosis, longer disease duration, cumulative prednisone dose and cyclophosphamide use.

CONCLUSIONS

Male sex, Mestizo ethnicity, comorbidities, thrombocytopenia, anti-dsDNA positivity and low complement levels were associated with LN occurrence. Cumulative damage was associated with older age at diagnosis, longer disease duration, higher cumulative dose of prednisone and the use of cyclophosphamide.

TRIAL REGISTRATION NUMBER: NCT04534647.