FRI0496 FRECUENCY OF POLYAUTOIMMUNITY IN RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERITHEMATOSUS
Authors: M. D. C. Ordoñez Cañizares, N. Mena-Vázquez, R. Redondo, S. Manrique Arija, I. Ureña, A. Fernandez-Nebro
Journal: Annals of the Rheumatic Diseases (2020)

Background: Objectives: To study the frequency of polyautoinmunity and multiple autoinmune syndrome (MAS) in patients with rheumatoid arthritis (RA) and systemic lupus erithematosus (SLE). Methods: Study design: We performed a cross-sectional study in patients with RA and SLE, and compared them with healthy subjects. Cases: RA patients classified by ACR/EULAR 2010 criteria and SLE patients classified by ACR/EULAR 2019 criteria. SLE and RA patients were compiled consecutively from a rheumatology clinic of the Regional University hospital of Malaga. Controls: subjects without rheumatologic autoimmune disease (AD) from the same population area. Protocol: All subjects filled out a predesigned questionnaire for the collection of polyautoimmunity data on the cut-off date. Main variables: polyautoimmunity was defined as co-occurrence of SLE or RA and other AD. Secondary variables: Rheumatologic, cutaneous, endocrine, digestive and neurological AD. MAS was defined as presence of three or more AD. Family history of SLE, RA and other autoimmune diseases were also collected. Statistic analysis: descriptive analysis, bivariate analysis and multivariable analysis were done. (Dependent variable: Polyautoimmunity). Results: We recruited 109 patients with RA, 105 with SLE and 88 controls. Fifteen patients with RA (13.8%), 43 with SLE (41%) and 2 controls (2.2%) reported polyautoimmunity. Table 1 describes the epidemiological characteristics, comorbidities and polyautoimmunity in study population. The most frequent AD associated with RA was Sjögren’s syndrome (SS) (53.3%) and SS (55.8%) followed by the antiphospholipid syndrome (30.2%) were associated with SLE. Hashimoto’s thyroiditis and psoriasis were the next most frequent AD. According to family history, 5 patients with RA (33.3%) and 12 with SLE (27.9%) had a family history of first degree of other AD. Obesity was associated with polyautoimmunity in RA (OR = 3,362, p = 0.034). In SLE, joint damage (OR = 2.282, p = 0.038) and anti-RNP antibodies (OR = 5.095, p = 0.028) were factors associated with polyautoimmunity and taking hydroxychloroquine was a protective factor (OR = 0.190, p = 0.004). Conclusion: Polyautoimmunity in RA and especially in SLE is frequent. It was associated with obesity in RA and in SLE with joint damage and anti-RNP antibodies. The hydroxychloroquine appeared as a protective factor. Variables RA (N=109) SLE (N=105) Controls (N=88) P value Epidemiological characteristics Sex: female, n (%) 85 (78.0) 99 (94.3) 68 (77.3) 0.001 Age, mean (SD), years 56.5 (10.8) 50.8 (13.2) 57.1 (10.6) 0.133 Caucasic race, n (%) 107 (98.2) 105 (100) 88 (100) 0.168 Comorbidities Smoking 0.001 No smoking, n (%) 55 (50.5) 78 (74.3) 56 (63.6) Smoking history, n (%) 54 (49.5) 27 (25.7) 32 (36.4) Obesity, n (%) 38 (34.9) 21 (20.0) 22 (25.0) 0.044 Dyslipidemia, n (%) 24 (22.0) 22 (21.2) 17 (19.3) 0.896 Hypertension, n (%) 27 (24.8) 28 (26.7) 23 (26.1) 0.746 Diabetes mellitus, n (%) 7 (6.4) 1 (1.0) 1 (1.1) 0.031 Polyautoimmunity, n (%) 15 (13.8) 43 (41) 2 (2.2) &lt;0.001 MAS, n (%) 1 (0.9) 9 (8,6) 0 (0.0) &lt;0.001 FH polyautoimmunity, n (%) 19 (17.6) 26 (24.8) 15 (17.0) 0.060 RA: rheumatoid arthritis; SLE: systemic lupus erithematosus; SD: standard desviation; MAS: multiple autoinmune syndrome; FH:Family history Disclosure of Interests: None declared