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AB0591 Organ Damage Evaluation and Risk Factors in a Cohort of 511 Sle Patients
  1. M. Taraborelli,
  2. N. Martinazzi,
  3. M.G. Lazzaroni,
  4. L. Andreoli,
  5. M. Fredi,
  6. Y. El Masri,
  7. S. Cartella,
  8. I. Cavazzana,
  9. M. Taglietti,
  10. M. Frassi,
  11. F. Franceschini,
  12. A. Tincani
  1. Rheumatology, Spedali Civili, Brescia, Italy

Abstract

Background Systemic lupus erythematosus (SLE) is still burdened by a significant morbidity and mortality.

Objectives To determine the prevalence of organ damage, with related risk factors, and mortality in a cohort of SLE patients.

Methods The clinical records of patients fulfilling the American College of Rheumatology (ACR) criteria for SLE, followed for at least 1 year in our center were retrospectively reviewed. Organ damage was assessed by the Systemic Lupus International Collaborating Clinics/ACR Damage Index (DI) at 1 year after diagnosis and then every 5 years, from the beginning until the end of the follow-up in our center. Disease activity was measured by the SLE Disease Activity Index (SLEDAI) 2K at the beginning of the follow-up. The comparison of characteristics between patients with and without damage at the end of their follow-up was performed by the Chi Square's, Fisher's exact and Student's t test as appropriate; p<0.05 was considered significant.

Results This study included 511 SLE patients (92% females, 95% Caucasians), followed in our Unit between 1972 and 2014, with a mean age at diagnosis of 33 years (±13) and a mean disease duration at the end of the follow-up of 16 (±9) years. One year after diagnosis 40% of patients with measurable DI (n=400) had accrued some damage and its prevalence gradually increased over time (Table I). At 1 year ocular (13%), central nervous system (12%) and skin (8%) damage were the most frequent whereas ocular, skin and musculoskeletal were the most frequent sites of damage (40%) at 35 years. Different features were significantly associated to damage (Table II). The main causes of death in 35 patients (7%) were cancer (33%) and organ failure (22%) after a mean disease duration of 13 years.

Conclusions The organ damage that accumulates over time in SLE is partly linked to disease activity, partly defined by clinical profiles (neuro-SLE, renal disease and Antiphospholipid Syndrome) that may require aggressive treatments. New, more effective and less toxic drugs could limit the progression of this process.

Disclosure of Interest None declared

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