Lupus and the LUMINA Study
By A. G. Moore
An Indian Enclave in Albuquerque, N.M.
Department of Agriculture
LUMINA was begun in 1993. One of the head researchers, Dr. Graciela S. Alarcon, explains how her interest in this area of research began. She describes seeing Mexican American women showing up for treatment when their lupus was already in an advanced, aggressive phase. She wanted to do something to help, and so when she was invited to participate in LUMINA, she jumped at the chance.
Eventually, LUMINA had an enrollment of more than 600 patients: 220 Hispanics, 224 African Americans and 181 Caucasians. The results of LUMINA showed that while genetic predisposition does play a role in ethnic expression of lupus, socioeconomic factors also are very influential. Level of education correlated very strongly with outcomes in the treatment of lupus, as did degree of poverty.
An interesting revelation of LUMINA was that in Hispanics and native Americans, lupus ran a course that mirrored the experience of African Americans.
Another interesting insight was that hydroxychloroquine (Plaquenil and Quinoric are two trade names for this medication) had “protective” effect “in terms of damage accrual”. This means that even for severe cases of lupus, addition of hydroxychloroquine to a treatment plan seemed to improve outcomes, especially where there was renal or skin involvement.
LUMINA is by no means the only study which has looked at socioeconomic influences on lupus outcomes. However, this study is very well regarded and has served as a valuable resource for researchers. The more that is understood about how the environment influences treatment and the course of lupus, the more effective will be the treatment plans that are designed to control this disease.