Objectives Individual autoantibodies are associated with the clinical features in patients with systemic lupus erythematosus (SLE). However, few studies have investigated differences in disease presentation based on autoantibody profiles in Asian patients with SLE. This study evaluated autoantibody clusters and compared the clinical and serological presentation and clinical outcome in Korean SLE patients.
Methods The Korean Lupus Network (KORNET) is a nationwide multicenter, hospital-based registry, set up to prospectively assess outcomes in Korean SLE patients. Of the 505 SLE patients enrolled in the KORNET registry from July 2014 to November 2015, the study group comprised 339 consecutive female SLE patients. Seven autoantibodies (anti-dsDNA, anti-Sm, anti-RNP, anti-Ro, anti-La, lupus anticoagulant (LAC), and anti-cardiolipin antibody [aCL]) were selected for cluster analysis using the K-means cluster analysis procedure.
Results Three distinct autoantibody clusters were identified: cluster 1, anti-dsDNA and anti-Ro; cluster 2, anti-RNP; and cluster 3, anti-RNP, anti-Ro, and anti-La. Compared with patients in clusters 2 (n=99) and 3 (n=85), patients in cluster 1 (n=155) had a shorter symptom duration before SLE diagnosis and higher incidence of biopsy-proven lupus nephritis. Patients in cluster 3 had a higher incidence of discoid rash, central nervous system involvement, lupus pancreatitis, pulmonary arterial hypertension, Raynaud's phenomenon, and premature gonadal failure. In addition, patients in cluster 3 had the lowest proportion of mean prednisolone >7.5 mg/day in the medication history.
Conclusions Autoantibody clusters were associated with the clinical features in women with SLE. Clustering autoantibodies could be a valuable approach for differentiating between various clinical subsets of SLE, and may help to guide prediction of the subsequent clinical course and organ damage in these patients.
Disclosure of Interest None declared