OP0249 ANTIPHOSPHOLIPID SYNDROME (APS) IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) LEADS TO A MORE SEVERE DISEASE
Authors: Leyre Riancho-Zarrabeitia, Victor Martinez Taboada, Iñigo Rua-Figueroa, Fernando Sánchez-Alonso, María Galindo-Izquierdo, Juan Ovalles, Alejandro Olivé, Antonio Fernandez-Nebro, Jaime Calvo, Raúl Menor Almagro, Eva Tomero Muriel, Esther Uriarte Isacelaya, Alina Boteanu, Mariano Andres, Mercedes Freire González, Gregorio Santos Soler, Esther Ruiz Lucea, Mónica Ibañez Barceló, Ivan Castellví, Carles Galisteo, Víctor Quevedo Vila, Enrique Raya, J. Narváez, Lorena Expósito, Josè Hernandez Beriain, Loreto Horcada, Jose M Pego-Reigosa
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in SLE patients. <h3>Objectives</h3> Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome. <h3>Methods</h3> Patients from the RELESSER-T registry were included. RELESSER-T is a multicenter, hospital-based registry, with retrospective cross-sectional collection of data from a large representative sample of adult non-selected patients with SLE attending Spanish rheumatology services from the public national health system. <h3>Results</h3> We included 3651 SLE patients and 1368 were positive for aPL (44.9% of patients were positive for anticardiolipin antibodies, 27.3% showed positivity for anti b2glycoprotein I and 24% for lupus anticoagulant). Overall 2283 patients were classified as SLE no aPL, 528 as SLE-APS and 840 as SLE-aPL. Demographic data, clinical and laboratory features in the different groups are showed in <b>Table 1</b>. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than SLE-aPL and SLE no aPL patients (<i>p</i>&lt; 0.001, <i>p</i>&lt; 0.001 and <i>p</i>=0,022, respectively). SLE-APS patients showed a lower prevalence of photosensitivity and higher frequencies of serositis, proteinuria (&gt;0.5 grs), urinary cell casts, seizures and psychosis (<i>p</i>≤0.001). Overall, SLE-APS patients showed a lower rate of cutaneous manifestations and higher rates of neuropsychiatric, cardiac, pulmonary, renal, joint and ophthalmological manifestations (<b>Table 1</b>). In accordance with a more severe clinical profile, higher frequency of anti-DNA antibodies and hypocomplementemia were observed in the SLE-APS group (<i>p</i>&lt;0.001). In addition to a higher disease activity (SLEDAI), SLE APS patients presented more damage accrual with higher values in SLICC (1.9±2.2 in SLE APS, 0.9±1. 4 in SLE aPL and 1.1±1.6, <i>p</i>&lt;0.001) and Katz indexes (3±1.8 in SLE APS, 2.7±1.7 in SLE aPL and 2.6±1.6 in SLE no aPL, <i>p</i> &lt;0.001). <h3>Conclusion</h3> SLE-APS patients show a more severe clinical profile with higher frequency of major organ involvement and more damage accrual than SLE-aPL and SLE no APL. <h3>Disclosure of Interests</h3> Leyre Riancho-Zarrabeitia Grant/research support from: Abbvie, Pfizer, UCB, MSD, GSK, Amgen, Roche travel grants, Victor Martinez Taboada: None declared, Iñigo Rua-Figueroa: None declared, Fernando Sánchez-Alonso: None declared, María Galindo-Izquierdo: None declared, Juan Ovalles: None declared, Alejandro Olivé Grant/research support from: ND, Consultant for: ND, Paid instructor for: ND, Speakers bureau: ND, Antonio Fernandez-Nebro: None declared, Jaime Calvo Consultant for: Bristol-Myers Squibb, Janssen, Celgene, Sanofi Genzyme, Speakers bureau: Bristol-Myers Squibb, Raúl Menor Almagro: None declared, Eva Tomero Muriel: None declared, Esther Uriarte Isacelaya: None declared, Alina Boteanu: None declared, Mariano Andres: None declared, Mercedes Freire González: None declared, Gregorio Santos Soler: None declared, Esther Ruiz Lucea: None declared, Mónica Ibañez Barceló: None declared, Ivan Castellví Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Carles Galisteo: None declared, Víctor Quevedo Vila: None declared, Enrique Raya: None declared, J. Narváez Consultant for: Bristol-Myers Squibb, Lorena Expósito: None declared, José A Hernandez Beriain: None declared, Loreto Horcada: None declared, Jose M Pego-Reigosa: None declared