AB0539 TEN YEARS OF THE MONASH LUPUS CLINIC: INSIGHT INTO THE CHARACTERISTICS AND OUTCOMES OF SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN AUSTRALIA
Authors: Rachel Koelmeyer, Sumanpreet Toor, Stellamay Gwini, Vera Golder, Eric F. Morand, Alberta Hoi
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The Monash Lupus Clinic, based at Monash Health in Melbourne, is Australia's first multi-disciplinary specialist lupus clinic that services a broad community and acts as a research hub, particularly as the foundation site and headquarters of the Australian Lupus Registry and Biobank (ALRB). Since its inception in 2007, the clinic has been co-run by rheumatologists and nephrologists. A carefully curated clinical dataset has been collected since clinic inception. <h3>Objectives:</h3> We provide an overview of the characteristics and longitudinal outcomes of adult lupus patients treated at the Monash Lupus Clinic over the last ten years. <h3>Methods:</h3> A ten-year-long dataset from the original Monash Lupus Clinic cohort, of patients subsequently enrolled in the Australian Lupus Registry and Biobank, was used for the analysis. The dataset included information on patient demographics, lupus diagnosis, serological profile, treatments, disease activity, damage accrual and other medical outcomes such as renal failure, adverse pregnancy outcomes and hospitalisations. Descriptive statistics were used to summarise the characteristics of the study population. Bivariate tests and regression analyses were used for comparisons between inception cohort patients, enrolled in the registry within 15 months of their Systemic Lupus Erythematosus (SLE) diagnosis, and existing SLE patients enrolled later in their disease course. <h3>Results:</h3> Of the 329 enrolled patients, the median age at enrolment was 38.0 years and 87.8% of were female. Most patients were either of Caucasian (48.6%) or Asian (36.5%) ethnicity. Patients were enrolled a median of 4.0 years after their SLE diagnosis; 31.0% of patients were inception cohort patients. Most patients (95.4%) had an abnormal titre of anti-nuclear antibodies; 65.0% of the cohort were positive for anti-dsDNA autoantibodies. Included patients were observed for a median observation period of 3.9 years. The median adjusted mean SLEDAI score over the observation period was 4.0; 49.1% of the cohort spent ≥50% of the observation period in the Lupus Low Disease Activity State and 43.5% had ever had a SLEDAI score ≥10. Just over half (57.4%) had accrued damage at the end of the observation period; however, pleasingly only a very small minority had an adverse pregnancy outcome (2.7%), developed renal failure (2.4%) or died (2.4%) during the observation period. Inception cohort patients did not appear to be different to existing SLE patients except for being a population of patients earlier in their disease course. <h3>Conclusion:</h3> Running a multi-disciplinary clinic alongside research activity is both feasible and worthwhile. Systematic collection of longitudinal data on SLE patients has shown that adverse outcomes such as end-stage renal disease and death are rare; however, with more than half of the cohort having damage present at the end of the observation period, there is still work to be done to improve outcomes for SLE patients in Australia. Expansion of the Australian Lupus Registry and Biobank beyond the Monash Lupus Clinic will provide further insight into the characteristics and outcomes of SLE patients in Australia and provide a beneficial framework for future studies. <h3>Disclosure of Interests:</h3> Rachel Koelmeyer Grant/research support from: AstraZeneca, UCB, GSK, Sumanpreet Toor: None declared, StellaMay Gwini: None declared, Vera Golder: None declared, Eric F. Morand Grant/research support from: AstraZeneca, Bristol Myers Squibb, Janssen, Merck Serono, and UCB, Consultant for: AstraZeneca, Eli Lilly, Janssen, and Merck Serono, Speakers bureau: AstraZeneca, Alberta Hoi Grant/research support from: GSK, AstraZeneca, UCB and Merck Serono, Consultant for: Janssen Steering Committee, Speakers bureau: Novartis