Tomic-Lucic, Aleksandra (36005544100)Aleksandra (36005544100)Tomic-LucicPetrovic, Radmila (35475760900)Radmila (35475760900)PetrovicRadak-Perovic, Marija (6507787195)Marija (6507787195)Radak-PerovicMilovanovic, Dragan (57204473227)Dragan (57204473227)MilovanovicMilovanovic, Jasmina (23502044000)Jasmina (23502044000)MilovanovicZivanovic, Sandra (35732872100)Sandra (35732872100)ZivanovicPantovic, Suzana (8339783800)Suzana (8339783800)PantovicVeselinovic, Mirjana (54418120000)Mirjana (54418120000)Veselinovic2025-06-122025-06-122013https://doi.org/10.1007/s10067-013-2238-yhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84880154202&doi=10.1007%2fs10067-013-2238-y&partnerID=40&md5=4d5da3241dfd9558f3a631470b759408https://remedy.med.bg.ac.rs/handle/123456789/9083There are contradictory opinions if late-onset systemic lupus erythematosus (SLE) is associated with a different, more benign disease course and better prognosis than early-onset SLE. The objective of this study was to evaluate the clinical manifestations, course, treatment, and prognosis of late-onset SLE. Patients who developed SLE after/or at the age of 50 years were considered late-onset SLE and compared to a group of randomly selected patients aged younger than 50 years at the diagnosis, matched for disease duration. Lower frequency of cutaneous manifestations (p = 0.01) and higher frequency of cytopenias (p = 0.02) were registrated at the SLE onset in the late-onset group. Atypical clinical presentation of SLE contributed to a longer delay of diagnosis in late-onset SLE patients (p = 0.005), who fullfiled less American College of Rheumatology criteria at the diagnosis (p = 0.022). Cumulative incidence of clinical manifestations showed lower frequency of cutaneous (p = 0.017), neuropsychiatric manifestations (p = 0.021), lupus nephritis (p = 0.006), and higher frequency of Sjogren′s syndrome (p = 0.025) in the late-onset group. Late-onset SLE patients received lower doses of corticosteroid (p = 0.006) and cyclophosphamide (p = 0.001) and had more cyclophosphamide- induced complications (p = 0.005). Higher prevalence of comorbid conditions in the late-onset group (p = 0.025), and higher Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index was noticed (p = 0.018). Despite the less major organ involvement and more benign course of disease, late-onset SLE has poorer prognosis, because of the higher frequency of comorbid conditions and higher organ damage, due to the aging and longer exposition to a classical vascular risk factors. © 2013 Clinical Rheumatology.Clinical manifestationsLate-onsetPrognosisSLE