Background There are contradictory opinions if late-onset systemic lupus erythematosus (SLE) is associated with a different, more benign disease course and better prognosis than early-onset SLE.
Objectives The objective of study was to evaluate the clinical manifestations, course, treatment and prognosis of late-onset SLE.
Methods Patients who developed SLE after/or at the age of 50 years were considered late-onset SLE and compared to a group of randomly selected patients aged younger than 50 years at the diagnosis, matched for disease duration.
Results Lower frequency of cutaneous manifestations (p=0.01) and higher frequency of cytopenia (p=0.02) was registrated at the SLE onset in late-onset group. Atypical clinical presentation of SLE contributed to a longer delay of diagnosis in late-onset patients (p=0.005), who fullfiled less American College of Rheumatology crteria at the diagnosis (p=0.022). Cumulative incidence of clinical manifestations showed lower frequency of cutaneous (p=0.017), neuropsychiatric manifestations(p=0.021), lupus nephritis (p=0.006) and higher frequency of Sjogren$′ $s syndrome (p=0.025) in late-onset group. Late-onset patients received lower corticosteroid (p=0.006) and cyclophosphamide doses (p=0.001), and had more cyclophosphamide induced complications (p=0.005). Higher prevalence of comorbid conditions was noticed in late-onset group. (p<0.0005).
Conclusions Despite the less maior organ involvement, and more benign course of disease, late-onset SLE has worse prognosis, because of the higher frequency of comorbid conditions, due to the aging and longer exposition to a classical vascular risk factors.
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Disclosure of Interest None Declared