ORIGINAL ARTICLE Antiphospholipid antibodies, steroid dose, arterial hypertension, relapses, and late-onset predict organ damage in a population of Colombian patients with systemic lupus erythematosus Luis F Pinto-Peñaranda 1 & C. Muñoz-Grajales 1 & A. F. Echeverri Garcia 1 & C. J. Velásquez-Franco 2 & M. A. Mesa-Navas 2 & M. Zuluaga Quintero 3 & S. Herrera-Uribe 4 & J. D. Márquez-Hernández 1 Received: 8 June 2017 /Revised: 24 October 2017 /Accepted: 21 November 2017 # International League of Associations for Rheumatology (ILAR) 2017 Abstract Organ damage predicts mortality, increased accrual of detriment, and poor quality of life in systemic lupus erythematosus patients. The objective of this study is to determine the damage-free survival and its predictive factors in a population of Colombian subjects. The method used in this study is the retrospective follow-up of a cohort; damage was measured with SLICC/ACR index. Predictors of impairment were assessed by logistic regression and survival analysis. One hundred sixty- one individuals were included; 28.9% suffered damage, primarily neuropsychiatric, renal, and vascular. Arterial hypertension, antiphospholipid antibodies, prednisone dose, and number of relapses were all predictors of detriment. Onset after age 50 and daily prednisone dose higher than 7.5 mg determined earlier occurrence of damage. Keywords Organ damage . SLICC/ACR SDI . Systemic lupus erythematosus Introduction Survival of patients with systemic lupus erythematosus (SLE), at 5 years, has increased from 50 to 90% between 1950 and 2000 [1–3], more than 80% at 20 years in some series [4, 5]. With survival improvement, irreversible organ damage repre- sents an important outcome, since it affects quality of life, [6, 7] increases morbidity and mortality, causing greater accumu- lation of impairment [8–10]. Disease onset after age 50, male gender [11], antiphospholipid, (APL) [12], anti-Ro and anti-DNA antibodies [13], nephritis, lupus activity, number of relapses, steroid dose, and use of immu- nosuppressants are related to organ damage [14, 15], while anti- malarials constitute protective factors [16]. The rate of accrual of impairment, as well as the factors that predict it, varies in different populations [17–19]. The purpose of this study was to determine the free- survival of organ damage, along with the factors that predict it, in a population of Colombian patients with SLE. Patients and methods A retrospective follow-up study was conducted on a co- hort that included all subjects with, at least, 16 years and four American College of Rheumatology (ACR) criteria at diagnosis and follow-up time for more than 1 year in a high-complexity hospital in Medellin, Colombia; we ex- cluded those with mixed connective tissue disease, drug- induced lupus, and overlap with systemic sclerosis or dermatomyositis. Lupus activity was measured with mean cumulative SELENA-SLEDAI scored during each clinic visit [20], and damage through SLICC/ACR SDI index [21]. Relapses were * Luis F Pinto-Peñaranda lfpreumatologo@hotmail.com 1 Rheumatology Department, Hospital Pablo Tobón Uribe, Calle 78B 69 - 240, Medellin, Colombia 2 Rheumatology Section, Clinica Universitaria Universidad Pontificia Bolivariana, Medellin, Colombia 3 Internal Medicine Department, Hospital Pablo Tobon Uribe, Medellin, Colombia 4 Hospital General de Medellin, Art Medica, Medellin, Colombia Clinical Rheumatology https://doi.org/10.1007/s10067-017-3927-8