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Objective <p>Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with diverse patterns of organ involvement, morbidity, and mortality. This study aimed to assess changes in demographic, clinical, and therapeutic characteristics of a single-center SLE cohort over the last two decades.</p> Materials and methods <p>This retrospective study included 409 SLE patients from the Rheumatology Department at Gazi University Faculty of Medicine, meeting the 2019 EULAR/ACR classification criteria. Patients were categorized by diagnosis year into two groups: 1987–2012 and 2013–2023.</p> Results <p>The proportion of male SLE patients increased approximately 2.5-fold in the last decade (5.2% vs. 12.6%, p = 0.008). While lupus nephritis rates remained stable, neurological (p = 0.012), hematological (p &lt; 0.001), pulmonary (p &lt; 0.001), and gastrointestinal (p &lt; 0.001) involvements were significantly higher in the last decade. Use of mycophenolate mofetil (p = 0.036), methotrexate (p &lt; 0.001), calcineurin inhibitors (p &lt; 0.001), and rituximab (p &lt; 0.001) increased, while steroid use (p = 0.044) and flare frequency (p = 0.035) decreased significantly. Although crude mortality rates improved (4.7% vs. 3.5%) without statistical significance (p = 0.54), male patients exhibited higher mortality rates than females (13.8% vs. 3.2%, p = 0.011). Hospitalization rates decreased but were not statistically significant (0.00130 vs. 0.00104/patient/year, p = 0.855).</p> Conclusion <p>Over the last two decades, SLE management has evolved with improved therapeutic approaches and changing clinical manifestations. However, mortality remains disproportionately higher in male patients, underscoring the need for targeted interventions.</p>

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Evolution of Clinical Characteristics and Treatment Strategies in Turkish SLE Patients Over Two Decades: A Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月13日

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  • Handenur Koç Kanık,
  • Abdulsamet Erden,
  • Derya Yıldırım,
  • Arif Burak Kanık,
  • Rahime Duran,
  • Rıza Can Kardaş,
  • Ibrahim Vasi,
  • Burcugül Kaya,
  • Hamit Küçük,
  • Abdurrahman Tufan,
  • Mehmet Akif Öztürk,
  • Berna Göker

摘要

Objective

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease with diverse patterns of organ involvement, morbidity, and mortality. This study aimed to assess changes in demographic, clinical, and therapeutic characteristics of a single-center SLE cohort over the last two decades.

Materials and methods

This retrospective study included 409 SLE patients from the Rheumatology Department at Gazi University Faculty of Medicine, meeting the 2019 EULAR/ACR classification criteria. Patients were categorized by diagnosis year into two groups: 1987–2012 and 2013–2023.

Results

The proportion of male SLE patients increased approximately 2.5-fold in the last decade (5.2% vs. 12.6%, p = 0.008). While lupus nephritis rates remained stable, neurological (p = 0.012), hematological (p < 0.001), pulmonary (p < 0.001), and gastrointestinal (p < 0.001) involvements were significantly higher in the last decade. Use of mycophenolate mofetil (p = 0.036), methotrexate (p < 0.001), calcineurin inhibitors (p < 0.001), and rituximab (p < 0.001) increased, while steroid use (p = 0.044) and flare frequency (p = 0.035) decreased significantly. Although crude mortality rates improved (4.7% vs. 3.5%) without statistical significance (p = 0.54), male patients exhibited higher mortality rates than females (13.8% vs. 3.2%, p = 0.011). Hospitalization rates decreased but were not statistically significant (0.00130 vs. 0.00104/patient/year, p = 0.855).

Conclusion

Over the last two decades, SLE management has evolved with improved therapeutic approaches and changing clinical manifestations. However, mortality remains disproportionately higher in male patients, underscoring the need for targeted interventions.