mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2016-1-56-62mrj-673Research ArticleОБЗОРЫREVIEWSНеобратимые органные повреждения у больных системной красной волчанкой. Индекс повреждения SLICCIrreversible organ damages in patients with systemic lupus erythematosus. SLICC damage indexСоловьеваЕ. С.SolovyevaE. S.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

АсееваЕ. А.AseevaE. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

eaasseeva@mail.ruЛисицынаТ. А.LisitsynaT. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

ПопковаТ. В.PopkovaT. V.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

СоловьевС. К.SolovyevS. K.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

НасоновЕ. Л.NasonovE. L.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115552

ФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical SciencesRussian Federation2016240320161015662Copyright © Соловьева Е.С., Асеева Е.А., Лисицына Т.А., Попкова Т.В., Соловьев С.К., Насонов Е.Л., 20162016Соловьева Е.С., Асеева Е.А., Лисицына Т.А., Попкова Т.В., Соловьев С.К., Насонов Е.Л.Solovyeva E.S., Aseeva E.A., Lisitsyna T.A., Popkova T.V., Solovyev S.K., Nasonov E.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/673

В статье представлен обзор литературы, демонстрирующий важность использования индекса повреждения (ИП) для комплексной оценки степени необратимых органных изменений у больных системной красной волчанкой (СКВ). Обоснованы необходимость и предпосылки создания этого надежного инструмента, разработанного в 1996 г. группой SLICC (Systemic Lupus International Collaborating Clinics). Подчеркивается, что появление ИП связано с ростом выживаемости больных СКВ в последние десятилетия и нарастанием у них необратимых органных повреждений, являющихся следствием как активности заболевания, так и проводимой терапии. Особое внимание уделяется объяснению возможности использования ИП не только для оценки степени необратимых органных повреждений у конкретного пациента, но и для выбора более адекватной терапии. Указывается, что по рекомендациям FDA (Управление по контролю за качеством пищевых продуктов и лекарственных препаратов США) и EULAR ИП включен в комплексную оценку проводимой терапии у пациентов с СКВ наряду с индексами активности (SLEDAI, BILAG).

The paper presents a literature review demonstrating the importance of using the damage index (DI) for the comprehensive evaluation of the degree of irreversible organ changes in patients with systemic lupus erythematosus (SLE). The need and prerequisites for creating this reliable tool developed by the Systemic Lupus International Collaborating Clinics (SLICC) Group in 1996 have been substantiated. The emergence of DI is emphasized to be associated with higher survivals in patients with SLE in the past decades and with an increase of their irreversible organ damages that were a consequence of both disease activity and performed therapy. Particular attention is given to the explanation for a possibility of using DI not only to estimate the degree of irreversible organ damages in a specific patient, but also to choose more adequate therapy. According to the guidelines of the US Food and Drug Administration (FDA) and the European League Against Rheumatism (EULAR), DI along with activity indices (SLEDAI, BILAG) is indicated to be included in the comprehensive assessment of performed therapy in patients with SLE.

индекс повреждениясистемная красная волчанкадлительность болезнивоспалительная активностьнеобратимые органные изменениятерапияисходиндивидуальный подходкачество жизниdamage indexsystemic lupus erythematosusdisease durationinflammatory activityirreversible organ changestherapyoutcomeindividual approachquality of lifeReferencesStrand V, Gladman D, Isenberg D, et al. Outcome measures to be used in clinical trials in systemic lupus erythematosus. J Rheumatol. 1999 Feb;26(2):490-7.Strand V, Gladman D, Isenberg D, et al. Outcome measures to be used in clinical trials in systemic lupus erythematosus. J Rheumatol. 1999 Feb;26(2):490-7.Gladman DD, Ginzler E, Goldsmith C, et al. The development and initial validation of the systemic lupus international collaborating clinics/American college of rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996 Mar;39(3):363-9.Gladman DD, Ginzler E, Goldsmith C, et al. The development and initial validation of the systemic lupus international collaborating clinics/American college of rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996 Mar;39(3):363-9.Gladman DD, Urowitz MB, Goldsmith CH, et al. The reliability of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index in patients with systemic lupus erythematosus. Arthritis Rheum. 1997 May;40(5):809-13.Gladman DD, Urowitz MB, Goldsmith CH, et al. The reliability of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index in patients with systemic lupus erythematosus. Arthritis Rheum. 1997 May;40(5):809-13.Gladman DD, Goldsmith CH, Urowitz MB, et al. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR)damage index for systemic lupus erythematosus inter-national comparison. J Rheumatol. 2000 Feb;27(2):373-6.Gladman DD, Goldsmith CH, Urowitz MB, et al. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR)damage index for systemic lupus erythematosus inter-national comparison. J Rheumatol. 2000 Feb;27(2):373-6.Rahman P, Gladman DD, Urowitz MB, et al. Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus. Lupus. 2001;10(2):93-6.Rahman P, Gladman DD, Urowitz MB, et al. Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus. Lupus. 2001;10(2):93-6.Nived O, Jonsen A, Bengtsson AA, et al. High predictive value of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for survival in systemic lupus erythematosus. J Rheumatol. 2002 Jul;29(7):1398-400.Nived O, Jonsen A, Bengtsson AA, et al. High predictive value of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for survival in systemic lupus erythematosus. J Rheumatol. 2002 Jul;29(7):1398-400.Cardoso CR, Signorelli FV, Papi JA, Salles GF. Initial and accrued damageas Predictors of mortality in Brazilian patients with systemic lupus erythemato-sus: a cohort study. Lupus. 2008 Nov;17(11):1042-8. doi: 10.1177/0961203308093829.Cardoso CR, Signorelli FV, Papi JA, Salles GF. Initial and accrued damageas Predictors of mortality in Brazilian patients with systemic lupus erythemato-sus: a cohort study. Lupus. 2008 Nov;17(11):1042-8. doi: 10.1177/0961203308093829.Stoll T, Seifert B, Isenberg DA. SLICC/ACR damage index is valid, and renal and pulmonary organ scores are predictors of severe outcome in patients with systemic lupus erythematosus. Br J Rheumatol. 1996 Mar;35(3):248-54.Stoll T, Seifert B, Isenberg DA. SLICC/ACR damage index is valid, and renal and pulmonary organ scores are predictors of severe outcome in patients with systemic lupus erythematosus. Br J Rheumatol. 1996 Mar;35(3):248-54.Тарасова ИА. Значение индекса повреждения в прогнозировании исхода системной красной волчанки. Диссертация на соискание ученой степени кандидата медицинских наук. Москва; 2003. 140 c. [Tarasova IA. Znachenie indeksa povrezhdeniya v prognozirovanii iskhoda sistemnoi krasnoi volchanki [The index of damage and prediction of outcome of systemic lupus erythematosus]. Diss. cand. med. sci. Moscow; 2003. 140 p.]Тарасова ИА. Значение индекса повреждения в прогнозировании исхода системной красной волчанки. Диссертация на соискание ученой степени кандидата медицинских наук. Москва; 2003. 140 c. [Tarasova IA. Znachenie indeksa povrezhdeniya v prognozirovanii iskhoda sistemnoi krasnoi volchanki [The index of damage and prediction of outcome of systemic lupus erythematosus]. Diss. cand. med. sci. Moscow; 2003. 140 p.]Gladman DD, Urowitz MB, Rahman P, et al. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol. 2003 Sep;30(9):1955-9.Gladman DD, Urowitz MB, Rahman P, et al. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol. 2003 Sep;30(9):1955-9.Alarcon GS, Roseman JM, Mc Gwin G Jr, et al. Systemic lupu serythematosus in three ethnic groups. XX. Damage as a Predictor of further damage. Rheumatology (Oxford). 2004 Feb;43(2):202-5. Epub 2003 Aug 15.Alarcon GS, Roseman JM, Mc Gwin G Jr, et al. Systemic lupu serythematosus in three ethnic groups. XX. Damage as a Predictor of further damage. Rheumatology (Oxford). 2004 Feb;43(2):202-5. Epub 2003 Aug 15.Ruiz-Irastorza G, Egurbide MV, Martinez-Berriotxoa A, et al. Antiphospholipid antibodies predict early damage in patients with systemic lupus erythematosus. Lupus. 2004;13(12):900-5.Ruiz-Irastorza G, Egurbide MV, Martinez-Berriotxoa A, et al. Antiphospholipid antibodies predict early damage in patients with systemic lupus erythematosus. Lupus. 2004;13(12):900-5.Cassano G, Roverano S, Paira S, et al. Accrual of organ damage over time in Argentine patients with systemic lupus erythematosus: a multi-centre study. Clin Rheumatol. 2007 Dec;26(12):2017-22. Epub 2007 Apr 6.Cassano G, Roverano S, Paira S, et al. Accrual of organ damage over time in Argentine patients with systemic lupus erythematosus: a multi-centre study. Clin Rheumatol. 2007 Dec;26(12):2017-22. Epub 2007 Apr 6.Chambers SA, Allen E, Rahman A, Isenberg D. Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years. Rheumatology (Oxford). 2009 Jun;48(6): 673-5. doi: 10.1093/rheumatology/kep062. Epub 2009 Apr 9.Chambers SA, Allen E, Rahman A, Isenberg D. Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years. Rheumatology (Oxford). 2009 Jun;48(6): 673-5. doi: 10.1093/rheumatology/kep062. Epub 2009 Apr 9.Urowitz MB, Gladman DD, Ibanez D, et al. Evolution of disease burden over five years in a multi center inception systemic lupus erythematosus cohort. Arthritis Care Res (Hoboken). 2012 Jan;64(1):132-7. doi: 10.1002/acr.20648.Urowitz MB, Gladman DD, Ibanez D, et al. Evolution of disease burden over five years in a multi center inception systemic lupus erythematosus cohort. Arthritis Care Res (Hoboken). 2012 Jan;64(1):132-7. doi: 10.1002/acr.20648.Bandeira M, Buratti S, Bartoli M, et al. Relationship between damage accrual, disease flares and cumulative drug therapies injuvenile-onset systemic lupus erythematosus. Lupus. 2006;15(8):515-20.Bandeira M, Buratti S, Bartoli M, et al. Relationship between damage accrual, disease flares and cumulative drug therapies injuvenile-onset systemic lupus erythematosus. Lupus. 2006;15(8):515-20.Becker-Merok A, Nossent HC. Damage accumulation in systemic lupus erythematosus and its relation to disease activity and mortality. J Rheumatol. 2006 Aug;33(8):1570-7.Becker-Merok A, Nossent HC. Damage accumulation in systemic lupus erythematosus and its relation to disease activity and mortality. J Rheumatol. 2006 Aug;33(8):1570-7.Lim LS, Lefebvre A, Benseler S, Silverman ED. Longterm outcomes and damage accrual in patients with childhood systemic lupus erythematosus with psychosis and severe cognitive dysfunction. J Rheumatol. 2013 Apr;40(4):513-9. doi: 10.3899/jrheum.121096. Epub 2013 Mar 1.Lim LS, Lefebvre A, Benseler S, Silverman ED. Longterm outcomes and damage accrual in patients with childhood systemic lupus erythematosus with psychosis and severe cognitive dysfunction. J Rheumatol. 2013 Apr;40(4):513-9. doi: 10.3899/jrheum.121096. Epub 2013 Mar 1.Sutton EJ, Davidson JE, Bruce IN. The systemic lupus international collaborating clinics (SLICC) damage index: a systematic literature review. Semin Arthritis Rheum. 2013 Dec;43(3):352-61. doi: 10.1016/j. semarthrit.2013.05.003. Epub 2013 Jun 17.Sutton EJ, Davidson JE, Bruce IN. The systemic lupus international collaborating clinics (SLICC) damage index: a systematic literature review. Semin Arthritis Rheum. 2013 Dec;43(3):352-61. doi: 10.1016/j. semarthrit.2013.05.003. Epub 2013 Jun 17.Ruiz-Irastorza G, Egurbide MV, Ugalde J, Aguirre C. High impact of antiphospholipid syndrome on irreversible organ damage and survival of patients with systemic lupus erythematosus. Arch Intern Med. 2004 Jan 12;164(1):77-82.Ruiz-Irastorza G, Egurbide MV, Ugalde J, Aguirre C. High impact of antiphospholipid syndrome on irreversible organ damage and survival of patients with systemic lupus erythematosus. Arch Intern Med. 2004 Jan 12;164(1):77-82.Andrade RM, Alarcon GS, Fernandez M, et al. Accelerated Damage accrual among men with systemic lupus erythematosus XLIV. Results From a multiethnic US cohort. Arthritis Rheum. 2007 Feb;56(2):622-30.Andrade RM, Alarcon GS, Fernandez M, et al. Accelerated Damage accrual among men with systemic lupus erythematosus XLIV. Results From a multiethnic US cohort. Arthritis Rheum. 2007 Feb;56(2):622-30.Al-Mayouf SM, Al SA. Influence of gender and age of onset on the outcome in children with systemic lupus erythematosus. Clin Rheumatol. 2008 Sep;27(9):1159-62. doi: 10.1007/s10067-008-0887-z. Epub 2008 Apr 18.Al-Mayouf SM, Al SA. Influence of gender and age of onset on the outcome in children with systemic lupus erythematosus. Clin Rheumatol. 2008 Sep;27(9):1159-62. doi: 10.1007/s10067-008-0887-z. Epub 2008 Apr 18.Maddison P, Farewell V, Isenberg D, et al. The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol. 2002 May;29(5):913-7.Maddison P, Farewell V, Isenberg D, et al. The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol. 2002 May;29(5):913-7.Appenzeller S, Pereira DA, Costallat LT. Greater accrual damage in late-onset Systemic lupus erythematosus: along-term follow-up study. Lupus. 2008 Nov;17(11): 1023-8. doi: 10.1177/0961203308089695.Appenzeller S, Pereira DA, Costallat LT. Greater accrual damage in late-onset Systemic lupus erythematosus: along-term follow-up study. Lupus. 2008 Nov;17(11): 1023-8. doi: 10.1177/0961203308089695.Karlson EW, Daltroy LH, Lew RA, et al. The relationship of socioeconomic status, race, and modifiable risk factors to outcomes in patients with systemic lupus erythematosus. Arthritis Rheum. 1997 Jan;40(1):47-56.Karlson EW, Daltroy LH, Lew RA, et al. The relationship of socioeconomic status, race, and modifiable risk factors to outcomes in patients with systemic lupus erythematosus. Arthritis Rheum. 1997 Jan;40(1):47-56.Prasad R, Ibanez D, Gladman D, Urowitz M. Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus. Lupus. 2006;15(5): 285-91.Prasad R, Ibanez D, Gladman D, Urowitz M. Anti-dsDNA and anti-Sm antibodies do not predict damage in systemic lupus erythematosus. Lupus. 2006;15(5): 285-91.Rivest C, Lew RA, Welsing PM, et al. Association between clinical factors, socioeconomic status, and organ damage in recent onset systemic lupus erythematosus. J Rheumatol. 2000 Mar;27(3):680-4.Rivest C, Lew RA, Welsing PM, et al. Association between clinical factors, socioeconomic status, and organ damage in recent onset systemic lupus erythematosus. J Rheumatol. 2000 Mar;27(3):680-4.Ravelli A, Duarte-Salazar C, Buratti S, et al. Assessment of damage in juvenile-onset systemic lupus erythematosus: a multicenter cohort study. Arthritis Rheum. 2003 Aug 15;49(4):501-7.Ravelli A, Duarte-Salazar C, Buratti S, et al. Assessment of damage in juvenile-onset systemic lupus erythematosus: a multicenter cohort study. Arthritis Rheum. 2003 Aug 15;49(4):501-7.Venkatesh I, Rukmangatharajan S, Rajeswari S, et al. S LICC-ACR damage index in childhood SLE. Indian J Rheumatol. 2010;5(3):S14.Venkatesh I, Rukmangatharajan S, Rajeswari S, et al. S LICC-ACR damage index in childhood SLE. Indian J Rheumatol. 2010;5(3):S14.Sung YK, Hur NW, Sinskey JL, et al. Assessment of damage in Korean patients with systemic lupus erythematosus. J Rheumatol. 2007 May;34(5):987-91. Epub 2007 Mar 15.Sung YK, Hur NW, Sinskey JL, et al. Assessment of damage in Korean patients with systemic lupus erythematosus. J Rheumatol. 2007 May;34(5):987-91. Epub 2007 Mar 15.Nossent JC. SLICC/ACR damage index in Afro-Caribbean patients with systemic lupus erythematosus: changes in and relationship to disease activity, corticosteroid therapy, and prognosis. J Rheumatol. 1998 Apr;25(4):654-9.Nossent JC. SLICC/ACR damage index in Afro-Caribbean patients with systemic lupus erythematosus: changes in and relationship to disease activity, corticosteroid therapy, and prognosis. J Rheumatol. 1998 Apr;25(4):654-9.Mok CC, Ho CT, Wong RW, Lau CS. Damage accrual in southern Chinese patients with systemic lupus erythematosus. J Rheumatol. 2003 Jul;30(7):1513-9.Mok CC, Ho CT, Wong RW, Lau CS. Damage accrual in southern Chinese patients with systemic lupus erythematosus. J Rheumatol. 2003 Jul;30(7):1513-9.Stoll T, Sutcliffe N, Mach J, Klaghofer R, Isenberg DA. Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus-a 5-yr prospective study. Rheumatology (Oxford). 2004 Aug;43(8):1039-44. Epub 2004 May 25.Stoll T, Sutcliffe N, Mach J, Klaghofer R, Isenberg DA. Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus-a 5-yr prospective study. Rheumatology (Oxford). 2004 Aug;43(8):1039-44. Epub 2004 May 25.Calvo-Alen J, Reveille JD, Rodriguez-Valverde V, et al. Clinical, immunogenetic and outcome features of Hispanic Systemic lupus erythematosus patients of different ethnic ancestry. Lupus. 2003;12(5):377-85.Calvo-Alen J, Reveille JD, Rodriguez-Valverde V, et al. Clinical, immunogenetic and outcome features of Hispanic Systemic lupus erythematosus patients of different ethnic ancestry. Lupus. 2003;12(5):377-85.Alarcon GS, Mc Gwin G Jr, Bartolucci AA, et al. Systemic lupus erythematosus in three ethnic groups IX. Differences in damage accrual. Arthritis Rheum. 2001 Dec;44(12):2797-806.Alarcon GS, Mc Gwin G Jr, Bartolucci AA, et al. Systemic lupus erythematosus in three ethnic groups IX. Differences in damage accrual. Arthritis Rheum. 2001 Dec;44(12):2797-806.Cooper GS,Treadwell EL, Clair EW, et al. Sociodemo-Graphic associations with early disease damage in patients with systemic lupus erythematosus. Arthritis Rheum. 2007 Aug 15;57(6):993-9.Cooper GS,Treadwell EL, Clair EW, et al. Sociodemo-Graphic associations with early disease damage in patients with systemic lupus erythematosus. Arthritis Rheum. 2007 Aug 15;57(6):993-9.Peschken CA, Esdaile JM. Systemic lupus erythematosus in North American Indians: a population based study. J Rheumatol. 2000 Aug;27(8):1884-91.Peschken CA, Esdaile JM. Systemic lupus erythematosus in North American Indians: a population based study. J Rheumatol. 2000 Aug;27(8):1884-91.Hiraki LT, Benseler SM, Tyrrell PN, et al. Ethnic differences in pediatric systemic lupus erythematosus. J Rheumatol. 2009 Nov;36(11):2539-46. doi: 10.3899/jrheum.081141. Epub 2009 Oct 15.Hiraki LT, Benseler SM, Tyrrell PN, et al. Ethnic differences in pediatric systemic lupus erythematosus. J Rheumatol. 2009 Nov;36(11):2539-46. doi: 10.3899/jrheum.081141. Epub 2009 Oct 15.Vila L, Alarcon G, McGwin G Jr, et al. Early clinical manifestations, disease activity and damage of systemic lupus erythematosus among two distinct US Hispanic subpopulations Rheumatology (Oxford). 2004 Mar;43(3):358-63. Epub 2003 Nov 17.Vila L, Alarcon G, McGwin G Jr, et al. Early clinical manifestations, disease activity and damage of systemic lupus erythematosus among two distinct US Hispanic subpopulations Rheumatology (Oxford). 2004 Mar;43(3):358-63. Epub 2003 Nov 17.Nossent J, Kiss E, Rozman B, et al. Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus. Lupus. 2010 Jul;19(8):949-56. doi: 10.1177/0961203 310366572. Epub 2010 Apr 7.Nossent J, Kiss E, Rozman B, et al. Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus. Lupus. 2010 Jul;19(8):949-56. doi: 10.1177/0961203 310366572. Epub 2010 Apr 7.Molad Y, Gorshtein A, Wysenbeek AJ, et al. Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort. Lupus. 2002;11(6):356-61.Molad Y, Gorshtein A, Wysenbeek AJ, et al. Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort. Lupus. 2002;11(6):356-61.Uziel Y, Gorodnitski N, Mukamel M, et al. Outcome of a national Israeli cohort of pediatric systemic lupus erythematosus. Lupus. 2007;16(2):142-6.Uziel Y, Gorodnitski N, Mukamel M, et al. Outcome of a national Israeli cohort of pediatric systemic lupus erythematosus. Lupus. 2007;16(2):142-6.Mikdashi J, Handwerger B. Predictors of neuropsychiatric damage in systemic lupus erythematosus: data from the Maryland lupus cohort. Rheumatology (Oxford). 2004 Dec;43(12):1555-60. Epub 2004 Sep 1.Mikdashi J, Handwerger B. Predictors of neuropsychiatric damage in systemic lupus erythematosus: data from the Maryland lupus cohort. Rheumatology (Oxford). 2004 Dec;43(12):1555-60. Epub 2004 Sep 1.Petri M. Hopkins Lupus Cohort. 1999 update. Rheum Dis Clin North Am. 2000 May;26(2):199-213.Petri M. Hopkins Lupus Cohort. 1999 update. Rheum Dis Clin North Am. 2000 May;26(2):199-213.Alarcon GS, McGwin G Jr, Bastian HM, et al. Systemic lupus erythematosus in three ethnic groups. VII [correction of VIII]. Predictors of early mortality in the LUMINA cohort. LUMINA Study Group. Arthritis Rheum. 2001 Apr;45(2):191-202.Alarcon GS, McGwin G Jr, Bastian HM, et al. Systemic lupus erythematosus in three ethnic groups. VII [correction of VIII]. Predictors of early mortality in the LUMINA cohort. LUMINA Study Group. Arthritis Rheum. 2001 Apr;45(2):191-202.Jonsen A, Clarke AE, Joseph L, et al. Association of the Charlson comorbidity index with mortality in systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2011 Sep;63(9):1233-7. doi: 10.1002/acr.20506.Jonsen A, Clarke AE, Joseph L, et al. Association of the Charlson comorbidity index with mortality in systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2011 Sep;63(9):1233-7. doi: 10.1002/acr.20506.Chen Y, Chen GL, Zhu CQ, et al. Severe systemic lupus erythematosus in emergency department: a retrospective single-center study from China. Clin Rheumatol. 2011 Nov;30(11):1463-9. doi: 10.1007/s10067-011-1826-y. Epub 2011 Aug 13.Chen Y, Chen GL, Zhu CQ, et al. Severe systemic lupus erythematosus in emergency department: a retrospective single-center study from China. Clin Rheumatol. 2011 Nov;30(11):1463-9. doi: 10.1007/s10067-011-1826-y. Epub 2011 Aug 13.Becker-Merok A, Eilertsen GO, Nossent JC. Low levels of transforming growth factor beta in systemic lupus erythematosus patients with active disease. Scand J Rheumatol. 2010;39:25.Becker-Merok A, Eilertsen GO, Nossent JC. Low levels of transforming growth factor beta in systemic lupus erythematosus patients with active disease. Scand J Rheumatol. 2010;39:25.Jackson M, Ahmad Y, BruceI N, et al. Activation of trans-forming growth factorbeta1and early atherosclerosis in systemic lupus erythematosus. Arthritis Res Ther. 2006;8(3):R81. Epub 2006 Apr 28.Jackson M, Ahmad Y, BruceI N, et al. Activation of trans-forming growth factorbeta1and early atherosclerosis in systemic lupus erythematosus. Arthritis Res Ther. 2006;8(3):R81. Epub 2006 Apr 28.Tam LS, Gladman DD, Hallett DC, et al. Effect of antimalarial agents on the fasting lipid profile in systemic lupus erythematosus. J Rheumatol. 2000 Sep;27(9):2142-5.Tam LS, Gladman DD, Hallett DC, et al. Effect of antimalarial agents on the fasting lipid profile in systemic lupus erythematosus. J Rheumatol. 2000 Sep;27(9):2142-5.Rahman P, Gladman DD, Urowitz MB, et al. The Cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs. J Rheumatol. 1999 Feb;26(2):325-30.Rahman P, Gladman DD, Urowitz MB, et al. The Cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs. J Rheumatol. 1999 Feb;26(2):325-30.Fessler BJ, Alarcon GS, McGwin G Jr, et al. Systemic lupus erythematosus in three ethnic groups XVI. Association of hydroxychloroquine use with reduced risk of damage accrual. Arthritis Rheum. 2005 May;52(5):1473-80.Fessler BJ, Alarcon GS, McGwin G Jr, et al. Systemic lupus erythematosus in three ethnic groups XVI. Association of hydroxychloroquine use with reduced risk of damage accrual. Arthritis Rheum. 2005 May;52(5):1473-80.Lilleby V, Flato B, Forre O. Disease duration, hypertension and medication Requirements are associated with organ damage in childhood-onset systemic lupus erythematosus. Clin Exp Rheumatol. 2005 Mar-Apr;23(2):261-9.Lilleby V, Flato B, Forre O. Disease duration, hypertension and medication Requirements are associated with organ damage in childhood-onset systemic lupus erythematosus. Clin Exp Rheumatol. 2005 Mar-Apr;23(2):261-9.Fangtham M, Petri M. 2013 Update: Hopkins Lupus Cohort. Curr Rheumatol Rep. 2013 Sep;15(9):360. doi: 10.1007/s11926-013-0360-0.Fangtham M, Petri M. 2013 Update: Hopkins Lupus Cohort. Curr Rheumatol Rep. 2013 Sep;15(9):360. doi: 10.1007/s11926-013-0360-0.Harward LE, Mitchell K, Pieper C, et al. The impact of cyclophosphamide on menstruation and pregnancy in women with rheumatologic disease. Lupus. 2013 Jan;22(1):81-6. doi: 10.1177/0961203312468624.Harward LE, Mitchell K, Pieper C, et al. The impact of cyclophosphamide on menstruation and pregnancy in women with rheumatologic disease. Lupus. 2013 Jan;22(1):81-6. doi: 10.1177/0961203312468624.Mosca M, Boumpas D, Bruce I, et al. Treat-to-target in systemic lupus erythematosus: where are we today? Clin Exp Rheumatol. 2012 Jul-Aug;30(4 Suppl 73):S112-5. Epub 2012 Nov 20.Mosca M, Boumpas D, Bruce I, et al. Treat-to-target in systemic lupus erythematosus: where are we today? Clin Exp Rheumatol. 2012 Jul-Aug;30(4 Suppl 73):S112-5. Epub 2012 Nov 20.

The authors declare that there are no conflicts of interest present.