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Dedicated to increasing awareness about
systemic lupus erythematosus (SLE), disease activity and related organ damage

Contributing Factors to
Organ Damage

Persistent disease activity may contribute to organ damage in patients with SLE. In addition to disease activity, drug-related side effects can result in accrual of organ damage, resulting in decreased quality of life, reduced work productivity, mood disorders, further organ damage, and death.1

Certain ethnic populations, such as Hispanics, African Americans, and Asians, are also more at risk than others.2

There is also a risk of organ damage accrual while the patient is completely unaware. For example, osteonecrosis may be asymptomatic in patients with SLE.4 Cardiovascular disease may also be subclinical in patients with SLE — prevalence of plaques in internal carotid arteries is 3 times higher and endothelial dysfunction, an early marker of atherosclerosis, is 2 times as common compared to the control group.5,6

Organ damage in SLE as assessed by the Systemic Lupus International Collaborating Clinics (SLICC) damage index is considered to be permanent.7

Disease activity in SLE may appear in different patterns — relapsing-remitting (RR), chronically active (CA), and long-quiescent.8-11

sle disease activity sle disease activity

DID YOU KNOW?

Prepubertal onset is associated with a greater risk of organ damage.3

LEARN MORE ABOUT SLE

This slide deck discusses the path to diagnosis of SLE, pathogenesis of the disease, impact on patients, and how to best support patients.

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What Next?

Quality of life is affected greatly in patients with SLE, making day-to-day life activities — cooking, family care, and sleeping — difficult to manage.12

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References:
1. Doria A. et al. Optimizing outcome in SLE: treating-to-target and definition of treatment goals. Autoimmun Rev. 2014;13(7):770-7. http://dx.doi.org/10.1016/j.autrev.2014.01.055. Accessed February 14, 2017. 2. Pons-Estel GJ, Alarcón GS, Scofield L, et al. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum. 2010;39(4):257. http://dx.doi.org/10.1016/j.semarthrit.2008.10.007. Accessed February 14, 2017. 3. Cervera R, Khamashta MA, Font J, et al. Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1000 patients. The European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore). 1993;72(2):113-24. http://www.ncbi.nlm.nih.gov/pubmed/8479324. Accessed February 14, 2017. 4. Houssiau FA, N'Zeusseu Toukap A, et al. Magnetic resonance imaging-detected avascular osteonecrosis in systemic lupus erythematosus: lack of correlation with antiphospholipid antibodies. Br J Rheumatol. 1998;37(4):448-53. http://dx.doi.org/10.1093/rheumatology/37.4.448. Accessed February 14, 2017. 5. Ahmad Y, Shelmerdine J, Bodill H, et al. Subclinical atherosclerosis in systemic lupus erythematosus (SLE): the relative contribution of classic risk factors and the lupus phenotype. Rheumatology (Oxford). 2007;46(6):983-8. http://dx.doi.org/10.1093/rheumatology/kem002. Accessed February 14, 2017. 6. El-Magadmi M, Bodill H, Ahmad Y, et al. Systemic lupus erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation. 2004;110(4):399-404. http://dx.doi.org/10.1161/01.CIR.0000136807.78534.50. Accessed February 14, 2017. 7. Gladman D, 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;39(3):363-369. http://dx.doi.org/10.1002/art.1780390303. Accessed February 14, 2017. 8. Steiman AJ, et al. [abstract]. Frequency and characteristics of prolonged remission in systemic lupus erythematosus. Arthritis Rheum. 2011;63(Suppl 10):1388. http://www.blackwellpublishing.com/acrmeeting/abstract.asp?MeetingID=781&id=96128. Accessed February 14, 2017. 9. Barr SG, Zonana-Nacach A, Magder, LS, et al. Patterns of disease activity in systemic lupus erythematosus. Arthritis Rheum. 1999;42:2682-2688. http://dx.doi.org/10.1002/1529-0131(199912)42:12<2682::AID-ANR26>3.0.CO;2-6. Accessed February 14, 2017. 10. Nikpour M, Urowitz MB, Ibañez D, et al. Frequency and determinants of flare and persistently active disease in systemic lupus erythematosus. Arthritis Rheum. 2009;61:1152-1158. http://dx.doi.org/10.1002/art.24741. Accessed February 14, 2017. 11. Zen M, Bassi N, Nalotto L, et al. Disease activity patterns in a monocentric cohort of SLE patients: a seven-year follow-up study. Clin Exp Rheumatol. 2012;30(6):856-863. http://www.ncbi.nlm.nih.gov/pubmed/22765883. Accessed February 14, 2017. 12. Katz P, Morris A, Trupin L, et al. Disability in valued life activities among individuals with systemic lupus erythematosus. Arthritis Rheum. 2008;59(4):465-473. http://dx.doi.org/10.1002/art.23536. Accessed February 14, 2017.