SLICC/ACR Damage Index in Afro-Caribbean patients with systemic lupus erythematosus: changes in and relationship to disease activity, corticosteroid therapy, and prognosis

J Rheumatol. 1998 Apr;25(4):654-9.


Objective: To apply the recently described Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) in a well defined cohort of patients with systemic lupus erythematosus (SLE) and to study its association with disease activity, corticosteroid therapy, and prognosis.

Methods: We conducted a record review of 90 patients with SLE followed at a single center for a mean period of 6 years with periodic evaluations of SLE Disease Activity Index (SLEDAI), cumulative damage according to SLICC/ACR-DI, and therapy. Overall disease activity during the disease course was calculated as weighted averages of SLEDAI (WAS).

Results: Mean SLICC/ACR-DI was 0.6 six months after diagnosis and increased to 2.4 at last assessment. Thirteen patients (14%) remained free of accumulated damage at last visit. Index scores showed significant correlations with WAS scores and the number of disease exacerbations (SLEDAI > 10), but not with age, mean daily, or cumulative corticosteroid dosage. High WAS scores were independently associated with poorer survival, but SLICC/ACR-DI scores were not.

Conclusion: SLICC/ACR-DI scores correlate with overall disease activity, but not with length or intensity of corticosteroid therapy. While easily applicable, its prognostic value is subordinate to that of persistent disease activity.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Africa / ethnology
  • Caribbean Region
  • Health Status Indicators*
  • Humans
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / pathology*
  • Middle Aged
  • Prognosis


  • Adrenal Cortex Hormones