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TOPLINE
Patients with juvenile-onset systemic lupus erythematosus (SLE) had an increased risk for relapse. Those with late-onset SLE were more likely to achieve remission and low disease activity but had higher mortality, mainly from infections.
METHODOLOGY
- Researchers conducted a retrospective cohort study to compare relapse, remission, and low disease activity outcomes among patients with SLE grouped by age at onset.
- They included 289 patients with SLE treated at a tertiary rheumatology center in Mexico City between 2000 and 2022. Patients were predominantly female.
- Patients were divided into three groups by age at onset: juvenile-onset SLE (younger than 18 years; n = 96), adult-onset SLE (18-49 years; n = 96), and late-onset SLE (50 years or older; n = 97).
- Remission was defined using standardized criteria, low disease activity using the Lupus Low Disease Activity State (LLDAS), and relapse using a validated flare index.
- The median follow-up duration was 12.5 years for juvenile-onset SLE, 7.6 years for adult-onset SLE, and 4.9 years for late-onset SLE.
TAKEAWAY
- Overall, 58.5% of patients achieved remission, 64.0% achieved LLDAS, and 59.5% had relapse.
- Late-onset SLE was independently associated with an increased likelihood of remission (adjusted hazard ratio [aHR], 2.8; adjusted P = .004) and LLDAS (aHR, 2.4; adjusted P = .006).
- The risk for relapse was elevated in patients with juvenile-onset SLE and in those with constitutional symptoms at diagnosis (adjusted P < .05 for both).
- Death was recorded in 18.6% of patients with late-onset SLE, with infections as the leading cause (88.8%).
IN PRACTICE
"The higher relapse rates and shorter relapse-free survival observed in jSLE [juvenile-onset SLE] suggest that these patients may benefit from closer longitudinal monitoring, earlier implementation of treat-to-target strategies and interventions aimed to reach disease control," the authors of the study wrote.
SOURCE
The study was led by Adriana Elizabeth Vázquez Hernández, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City. It was published online on September 15, 2026, in Rheumatology.
LIMITATIONS
The study was retrospective and relied on medical records; thus, some data may have been missing or inaccurate. Referral pathways differed by age, which may have introduced selection or information bias. Treatment approaches changed over the long study duration.
DISCLOSURES
The study did not receive any specific funding. The authors did not declare any conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
