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Men With Systemic Lupus Erythematosus Fare Worse Than Women, Study Confirms

By Maggie Schwarz

WASHINGTON, DC -- November 13, 2006 -- Male gender is a strong predictor of target organ damage in systemic lupus erythematosus (SLE) early in the course of disease, according to a study reported here at the American College of Rheumatology - Association of Rheumatology Health Professionals Annual Scientific Meeting (ACR-ARHP).

"Men with SLE should be treated more aggressively, earlier in their disease," asserted Rosa M. Andrade, MD, research post-doctoral fellow, University of Alabama, Birmingham, Alabama, in a presentation on November 12^th.

Men are believed to suffer more renal, neurological, and cardiovascular involvement than do women but no clinical studies have confirmed or denied this belief. Dr. Andrade and colleagues therefore set out to determine the whether gender plays any role in severity of SLE. The investigators believed their institution was an excellent site to study SLE longitudinally because it has a multiethnic patient population. They studied the cohort for 10 years.

The study enrolled patients with SLE 16 years and older and had disease duration no greater than 5 years at enrollment. The cohort consisted of Hispanics, African Americans and Caucasians. Socioeconomic-demographic, clinical and serological manifestations as well as disease activity (SLAM-R) and damage accrual (SLICC damage index or SDI) were compared between male and female patient groups.

Sixty-three male SLE patients (10.2%) from all ethnic groups were included. Mean ages for male and female patients were comparable.

Caucasians, smokers, alcohol drinkers, presence of positive lupus anticoagulant (LAC) and renal involvement were more frequent among male patients, whereas musculoskeletal involvement was less common. Time to accrual of ACR criteria and disease duration were shorter in male patients; damage was more common and of higher magnitude in men.

Positive LAC, shorter disease duration and higher early damage were independently associated with male SLE. Male gender was a strong predictor of damage, early in the course of disease.
Dr. Andrade concluded that, though men and women with SLE appeared similar in their clinical profiles, men accrued ACR criteria for SLE 17 months earlier than women and entered the cohort with greater baseline organ damage.

"Men require higher doses of prednisone and generally do worse than women, not specifically in any particular organ system but overall," Dr. Andrade stated.


[Presentation title: Andrade: Accelerated Damage Accrual Among Male System Lupus Erythematosus Patients: Results From a Multiethnic US Cohort. Abstract 557]

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