Background There is little information about the level of activity and the refractoriness to the treatment of the SLE patients in Spain.
Objectives To study the level of activity and calculate the percentage of SLE patients who are refractory to the therapies.
Methods Patients. SLE patients from the RELESSER Registry with active follow up in a Rheumatology Department.
Variables. a) clinical and analytical activity manifestations and b) past and current treatments.
Methods. Retrospective study of the data collected at the time of the last evaluation of the patient. a) the SELENA-SLEDAI score is calculated and the SLE activity stratified according to that score, b) the percentage of refractory cases is calculated according to predefined criteria: inefficacyof cyclophosphamide (CYC), use of rituximab, splenectomy or inefficacy of ≥2 immunosupressors (methotrexate, leflunomide, abatacept, anti-TNF, azathioprine, CYC, mycophenolate mofetil and/or mycophenolic acid).
Results 583 patients were included (88.3% females, mean age: 45.5 years, SLE duration: median 111 months). At the time of the study, the most frequent clinical manifestations of activity were mucocutaneous (13.9%) and musculoskeletal (6.3%). The least frequent clinical features were myositis and psychosis (0% both). There was renal or neurological/psychiatric activity in the 7.8% and 2.3% of the patients, respectively. From the analytical perspective, 13.6% of the patients had leukopenia. 27 (4.6%) patients had hypocomplementemia and anti-dsDNA antibodies without any clinical manifestation. The median SLEDAI score was: 2 (range: 0-23). 39.4% of patients had a SLEDAI score =0. SLE disease activity was mild (1-4 points), moderate (5-9) and severe (≥10) in 43.4, 13.2 and 3.9% of patients, respectively.
The table shows the treatments for lupus that received the patients in each activity level group. 59 (10.1%) of the patients presented moderate or severe activity in spite of being on corticosteroid and antimalarial treatment.
The percentage of refractoriness, according to the definition in the “Methods” section, was 10.3% of the patients.
Conclusions The level of disease activity of the lupus patients followed in Spanish Rheumatology Departments is relatively low. An important percentage of the patients (10.1%) has moderate-severe lupus activity in spite of the use of corticosteroids and antimalarials. The percentage of refractoriness of the SLE might be about the 10% of the patients.
Disclosure of Interest None Declared
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