Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years.

OBJECTIVE: To study damage accrual and mortality in British patients with SLE under long-term follow-up for >10 years. METHODS: We analysed the clinical records of 232 patients with SLE who had at least 10 years of consistent follow-up at University College London Hospital (UCLH). We noted their SLICC/ACR Damage Index (SDI) scores and category of damage at 1 year post-diagnosis of SLE and every 5 years thereafter. For patients who had died, we determined the year and cause of death. RESULTS: Ninety per cent of patients had no damage at 1 year post-diagnosis of SLE; however by year 10, 50% had accrued some damage. Damage accrual was mostly in the neuropsychiatric, renal and musculoskeletal categories. An increase in damage score was associated with a higher risk of death overall. Forty-four patients died during the period of follow-up. Sepsis, cancer and organ failure (cardiac, renal and liver) were the main causes of death in this group of patients. CONCLUSIONS: Damage accrual is associated with an increased risk of mortality. Infections remain an important cause of death in patients with SLE.