Background New Zealand became a member of the Asia Pacific Lupus Collaboration (APLC) group in 2018. The APLC treat-to-target (T2T) LLDAS study is an ongoing, prospective longitudinal study (n = 4,106).
The aim of this study was to: (1) assess SLE epidemiology from the Auckland cohort of APLC T2T LLDAS study, and (2) examine if there are ethnic differences in association with the ability to achieve LLDAS, with emphasis on lupus nephritis.
Methods All patients fulfilled either the ACR or SLICC lupus criteria. At each study visit (3 to 6 monthly), patients are assessed for flares using SLEDAI-2K. Information on medication and laboratory data are collected. Patients are assessed annually for SLE damage.
Results 144 patients from 3 Auckland hospitals were recruited during 2018–2020. The ethnic breakdown was Asian 42%, European 33%, Pacific Island (PI) 19% and Maori 4.9%. Arthritis (n=115, 80%), was the most common clinical feature. 41 patients (28%) had renal disease.
The incidence of SLE in Auckland is 6.32 per 100,000. Asian (n=23/60, 38%) and PI patients (n=9/28, 32%) had more renal disease (p=0.03). PI patients had proportionally more proliferative (Class III/IV) lupus nephritis that can potentially lead to long term renal damage compared to the other ethnic groups (n=8/9, 89%; p =0.046). 76% (n=109) of patients achieved LLDAS on at least one occasion. 90% (n= 129) of patients were on hydroxychloroquine. The mean SDI damage score is 0.4.
Conclusions This is the first NZ study to provide prospective data on SLE disease activity and damage. There are ethnic differences in lupus nephritis with over representation in Asian and PI patients.
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