{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:30:00Z","timestamp":1792092600224,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01 DP006701"],"award-info":[{"award-number":["U01 DP006701"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Differential disease control may contribute to racial disparities in outcomes of childhood\u2010onset systemic lupus erythematosus (cSLE). We evaluated associations of race and individual\u2010 or neighborhood\u2010level social determinants of health (SDoH) with achievement of low lupus disease activity state (LLDAS), a clinically relevant treatment target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cSLE cohort study using the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry, the primary exposure was self\u2010reported race and ethnicity, and collected SDoH included insurance status and area deprivation index (ADI). Outcomes included LLDAS, disease activity, and time\u2010averaged prednisone exposure. Associations among race and ethnicity, SDoH, and disease activity were estimated with multivariable regression models, adjusting for disease\u2010related and demographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 540 children with cSLE, 27% identified as Black, 25% identified as White, 23% identified as Latino\/a, 11% identified as Asian, 9% identified as more than one race, and 5% identified as other. More Black children (41%) lived in neighborhoods of highest ADI compared to White children (16%). Black race was associated with lower LLDAS achievement (adjusted odds ratio 0.56, 95% confidence interval [CI] 0.38\u20130.82) and higher disease activity (adjusted \u03b2 0.94, 95% CI 0.11\u20131.78). The highest ADI was not associated with lower LLDAS achievement on adjustment for renal disease and insurance. However, renal disease was found to be a significant mediator (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04) of the association between ADI and prednisone exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with cSLE who identified as Black are less likely to achieve LLDAS and have a higher disease activity. Living in areas of higher ADI may relate to renal disease and subsequent prednisone exposure. Strategies to address root causes will be important to design interventions mitigating cSLE racial disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25443","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T01:51:47Z","timestamp":1727661107000},"page":"38-49","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Racial Disparities and Achievement of the Low Lupus Disease Activity State: A\n                    <scp>CARRA<\/scp>\n                    Registry Study"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-3520","authenticated-orcid":false,"given":"William Daniel","family":"Soulsby","sequence":"first","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Olveda","sequence":"additional","affiliation":[{"name":"Palo Alto 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Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt J.","family":"Greenlund","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1913-6472","authenticated-orcid":false,"given":"Laura E.","family":"Schanberg","sequence":"additional","affiliation":[{"name":"Duke University  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"von Scheven","sequence":"additional","affiliation":[{"name":"University of California  San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8785-0010","authenticated-orcid":false,"given":"Aimee","family":"Hersh","sequence":"additional","affiliation":[{"name":"University of Utah  Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth F.","family":"Son","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Chang","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital and Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4278-9049","authenticated-orcid":false,"given":"Andrea","family":"Knight","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children and University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CARRA Registry 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