FRI0235 DIFFERENCES BETWEEN MALE AND FEMALE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SINGLE CENTER EXPERIENCE OVER 20 YEARS OF FOLLOW-UP
Authors: Micaela Fredi, Federica Tomasoni, Laura Andreoli, Ilaria Cavazzana, Angela Tincani, Franco Franceschini
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown etiology involving multiple organ systems. It affects predominantly women, and according to different reports only 4–22% of the lupus population is male. Sex differences may influence the clinical and serological expression, therapy and outcome, but the current results varies among different countries and different ethnic groups (1-3). Less is known about the clinical course of male SLE during the follow-up due to the small number of cases collected, but male sex might be a poor factor in SLE prognosis (4-9). <h3>Objectives</h3> The aim of this work was to analyze our male and female SLE patients with an ongoing follow-up. <h3>Methods</h3> Cumulative clinical, serological manifestations, concomitant diseases of patients belonging to the historical SLE cohort with at least one evaluation in the past 15 months were collected from clinical charts. For these patients data regarding the overall and ongoing treatments, damage index (SDI), activity index (SLEDAI-2K) during the last 12 months were collected. For statistical analysis was used Chi-squared test, Fisher exact test, Student T test or Wilcoxon-Mann Whitney when appropriated. <h3>Results</h3> Out of the 550 SLE patients registered until may 2018 we have included for this analysis 345 patients with an active follow-up, 31 males and 314 females, with a male to female ratio of 1:10. A higher number of SLE male had disease onset (13% vs 1.6%) and diagnosis (16% vs 1.6%) after 60 years compared to female (p=0.001; OR 9.1; 95%CI 1.92-42.56 and p&lt;0.0001; OR11.8; 95% CI 2.73-51.56 respectively). The most relevant differences among male and female patients are reported in the table 1. Males more frequently presented discoid lesions, renal involvement, polyneuropathy and leukopenia compared to female SLE. No difference regarding disease activity during the last 12 months measured by SLEDAI was found. Regarding the damage index, males showed a higher mean SDI and number of patients with a severe damage (SDI&gt;2) compared with women. Analyzing treatment prescribed since the diagnosis of SLE we collected some relevant differences: antimalarials were less prescribed in males than females (87%vs 97%, p=0.02; OR 0.19; 95%CI 0.051–0.825), whereas mycophenolate mofetil was more frequently used in males (63%vs36%, p=0.005 OR 3.0 95% CI1.3- 6.8). Finally, significant differences regarding the ongoing treatment are reported in table 1: mycophenolate mophetile was more frequently prescribed in males (84,2 vs 25,6) and a highly suggestive trend of significance toward a greater use of steroids in males was also found. <h3>Conclusion</h3> Our study confirmed the presence of differences between male and female SLE patients, both on clinical manifestations and also during the disease course. Our results on currently followed male SLE confirmed that these patients have a more severe disease, in particular with renal or neurological manifestations, that could justify the higher use of mycophenolate mofetile and the higher SDI compared to female SLE. <h3>References</h3> [1] S.P. Ballou, et al.Arthritis Rheum. 25 (1) (1982) 55–60. [2] L.J. Lu, et al., Lupus 19 (2) (2010)119–129. [3] Isenberg DA, et al. Br J Rheumatol 1994;33:3078. [4] Andrade RM, Arthritis Rheum (2007) 56(2):622–30 [5] Garcia MA, et al.. Lupus (2005) 14(12):938–46. [6] Taraborelli M, et al. Lupus (2017) 11:1197-1204 [7] Tan TC, et al. J Rheumatol (2012) 39(4):759–69. [8] Kamen DL, et al. Arthritis Rheum (2008) 58(5):1237-47 <h3>Disclosure of Interests</h3> Micaela Fredi: None declared, Federica Tomasoni: None declared, Laura Andreoli: None declared, Ilaria Cavazzana: None declared, Angela Tincani Consultant for: UCB, Pfizer, Abbvie, BMS, Sanofi, Roche, GSK, AlphaSigma, Lillly, Jannsen, Cellgene, Novartis, Franco Franceschini: None declared