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Men with lupus had greater disease activity compared with women
Men with systemic lupus erythematosus had more disease activity than female counterparts and a poor prognosis without timely and appropriate interventions, according to a study.
Researchers in Peking, China, reviewed 516 hospitalized patients (58 men) with systemic lupus erythematosus (SLE) in a 3-year study. The median ages at disease onset were 27.2 years and 28.6 years for men and women, respectively. Researchers compared clinical manifestations, laboratory profiles and disease activity scores.
Compared with women, men with SLE had higher rates of serious renal disease (58.6% vs. 47.2%) and neuropsychiatric SLE (20.7% vs. 12%); higher incidence of anti-dsDNA (25.9% vs. 16.8%), anti-Sm (17.2% vs. 8.7%; P=.002), anti-Ro (46.6% vs. 28.4%; P=.004), anti-RNP (29.3% vs. 15.3%) and anticardiolipin antibody (25.9% vs. 11.4%; P=.004). Men also had low C3 levels (67.2% vs. 49.8%; P=.009) and higher SLE disease activity index scores (16.8% vs. 12.8%; P=.038).
Twenty-four of the men with SLE had not received aggressive treatment 3 months before the study. When compared with a control of 25 men with no history of autoimmune disease, their testosterone and dehydroepiandrosterone levels were lower (P=.004 and P=.006, respectively). Low testosterone was a risk factor for developing lupus nephritis (OR=1.203; 95% CI, 1.021-1.483), while high serum prolactin increased the risk for neuropsychiatric SLE (OR=0.761; 95% CI, 0.554-0.945).
“Early recognition of SLE risk factors and the institution of appropriate treatment are essential,” the researchers concluded. “The low incidence and prevalence of SLE in male patients has led to many paradoxical findings. Determining the importance of sex-specific factors in SLE requires collaborative work between clinical and basic research in well-designed, multicenter controlled trials.”