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JSLE linked to higher CVD risk factors than JDM in adults with childhood-onset autoimmune diseasesStudy compares heart health risks in adults with childhood-onset lupus or dermatomyositis

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Key Takeaway
Consider higher CVD risk factors in JSLE vs. JDM adults from childhood-onset disease.

This single-centre longitudinal cohort study compared adults with childhood-onset juvenile systemic lupus erythematosus (JSLE, n=76) and juvenile dermatomyositis (JDM, n=79), with mean follow-up of 10.0 ± 4.2 years for JSLE and 11.0 ± 5.1 years for JDM. The JSLE cohort was older at assessment (mean age 24.3 ± 4.2 years vs. 20.1 ± 5.0 years for JDM, p<0.001), but follow-up duration did not differ significantly (p=0.68). JSLE showed higher prevalence of hypertension (p=0.02) and dyslipidaemia (p=0.0005), and higher total cholesterol (p=0.01) and LDL-cholesterol levels (p=0.02) compared to JDM. Damage accumulation was not significantly different between cohorts (JSLE: 39/76 or 51.3%, JDM: 47/79 or 59.4%, p=0.307), but body mass index independently predicted damage in both (JSLE: p=0.038, JDM: p=0.026). The PDAY score for cardiovascular disease (CVD)-risk stratification was higher in JSLE (median 5 points, range 4-13) than JDM (median 0 points, range 0-3, p=0.0001), though adult CVD-risk scores were very low in both. Safety and tolerability were not reported. Key limitations include the observational design, which shows associations not causation, and the single-centre setting, which may limit generalizability. Practice relevance is not reported, but clinicians should note these findings as preliminary evidence from a specific cohort, requiring confirmation in larger, multi-centre studies.

This study looked at adults who had childhood-onset systemic autoimmune rheumatic diseases, specifically juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM). It involved 76 people in the JSLE group and 79 in the JDM group, all from a single medical center, and followed them for an average of about 10 years to see how their health changed over time.

The main findings showed that adults with JSLE had higher rates of hypertension and dyslipidaemia, as well as higher total and LDL cholesterol levels, compared to those with JDM. Both groups had similar levels of damage accumulation, but higher body mass index was linked to more damage in both. The study also used a score to estimate heart disease risk, finding it was higher in the JSLE group, though overall adult cardiovascular risk scores were very low in both.

No safety concerns were reported, but it's important to be cautious because this was an observational study from one center, meaning it shows associations rather than proving causes. The results may not apply to everyone with these conditions. Readers should take this as early evidence that heart health risks might differ between these diseases, but more research is needed to confirm these findings and understand what they mean for care.

What this means for you:
Adults with childhood lupus may have higher heart risks than those with dermatomyositis, but this is based on a small observational study.

Study Details

Study typeCohort
Sample sizen = 76
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Objectives: Juvenile systemic lupus erythematosus (JSLE) and juvenile dermatomyositis (JDM) are systemic autoimmune rheumatic diseases (RMDs) with childhood-onset associated with increased risk of damage accumulation and cardiovascular disease (CVD) over the life course. Methods: Damage associated with JSLE and JDM has been assessed using validated outcome measures in a longitudinal single-centre cohort study with long-term follow-up, involving data collected both retrospectively and prospectively. Descriptive statistics, sensitivity and regression analyses have been used to evaluate predictors of damage and CVD-risk. Results: We assessed comparatively a JSLE cohort (n=76), with a mean age of 24.3 +/- 4.2 years and a JDM cohort (n=79) with a mean 20.1 +/-5.0 years (p<0.001), with matched duration of follow-up (10.0 +/- 4.2 vs. 11.0 +/- 5.1, respectively, p=0.68). Traditional CVD-risk factors, including hypertension (p=0.02), dyslipidaemia (p=0.0005), and higher total cholesterol (p=0.01) and LDL-cholesterol (p=0.02) levels at the last assessment were higher in JSLE vs. JDM. Over the disease course, 39 (51.3%) AYA with JSLE vs. 47 (59.4%) AYA with JDM accumulated damage (p=0.307), which was independently predicted by the body mass index in both cohorts (p=0.038 and p=0.026, respectively). The PDAY score was the only tool able to stratify AYA based on CVD-risk (median = 5 (4-13) points in JSLE vs. 0 (0-3) points in JDM, p=0.0001), as all the adult CVD-risk scores were very low in both cohorts. Conclusions: This is the first comparative evaluation of JSLE vs. JDM in adulthood, which highlighted increased damage burden and CVD-risk in JSLE that warrants further investigation.
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