Transition to severe phenotype in systemic lupus erythematosus initially presenting with non-severe disease: implications for the management of early disease.

Factors associated with this transition in multivariable analysis were male sex (OR 4.53, 95% CI 1.23 to 16.60), disease duration (OR 1.09, 95% CI 1.04 to 1.14) and especially neuropsychiatric involvement at onset (OR 6.33, 95% CI 1.22 to 32.67); presence of anti-dsDNA marginally did not reach statistical significance (OR 1.89, 95% CI 0.96 to 3.73).

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For both transitions (ie, from mild to moderate, as well as from mild/moderate to severe), patients with late-onset SLE showed a trend to retain their initial phenotype compared with patients diagnosed before the age of 50, only in univariable analyses ( tables 2 and 3 ).

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