AB1074 A SUBTLE IMMUNOLOGICAL PROFILE DISTINCTION BETWEEN LUPUS LOW DISEASE ACTIVITY STATE-CLINICALLY ACTIVE AND LUPUS LOW DISEASE ACTIVITY STATE-SEROLOGICALLY ACTIVE CLINICALLY QUIESCENT
Authors: W. Piriyasanguanpong, B. Siripaitoon, P. Intapiboon
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Achievement of disease remission or lupus low disease activity state (LLDAS) is a targeted strategy convinced by the current SLE management recommendations. However, a knowledge gap exists in how immunological profiles and clinical outcomes diverge between LLDAS subgroups. <h3>Objectives:</h3> This study aims to evaluate the immunological profiles using cytokine measurement in two LLDAS subgroups. <h3>Methods:</h3> This prospective cohort study was conducted at Songklanagarind Hospital, Thailand, from January to December 2023. We included the patients with SLE, aged 18–60 years old, who achieved LLDAS for at least six months. All patients provided written informed consent to participate in the study. We classified the participants into 2 groups equally according to clinical and serological activity. Lupus Low Disease Activity State-Clinically Active (LLDAS-CA) was defined as SLEDAI-2K score 1-4 of clinical scores. Lupus Low Disease Activity State-Serologically Active Clinically Quiescent (LLDAS-SACQ) was defined as SLEDAI-2K score 2-4 of serological scores. Throughput Flow Cytometry Blood-based Multiplex Assay was used to measure 13 cytokines at the date of enrollment. All participants were followed up within six months to evaluate SLE disease activity. <h3>Results:</h3> We included 50 patients with SLE who achieved sustained LLDAS. Their baseline characteristics were summarised in Table 1. Most patients were female (92%), and the mean (SD) SLE disease duration was 9.9 (7.2) years. The median (IQR) duration of LLDAS attainment was 3.1 (1.5, 6.7) years. Low-dose prednisolone and hydroxychloroquine were continued in almost all patients, while combined with azathioprine was significantly remarkable in LLDAS-SACQ (64% vs 28%, <i>p</i> = 0.023). Regarding the results, we found that all tested cytokine levels were above the upper normal limit except IL-17A. Comparing between groups, IL-6 and IL-8 levels were significantly higher in LLADS-CA [(59.9 vs. 27.3 pg/ml; <i>p</i>=0.035) and (2179.7 vs. 1190.5 pg/ml; <i>p</i>=0.049), respectively] (Figure 1). However, no significant difference existed between groups after univariate and multivariate analyses. Overall, we found 9 patients reported disease flare-ups, 6 in LLADS-CA, and 3 in LLDAS-SACQ groups, after a six-month follow-up period. <h3>Conclusion:</h3> In the present study, most tested cytokines were elevated despite achieving LLDAS. This study demonstrated that serum IL-6 and IL-8 levels were higher in patients with LLDAS-CA than with LLDAS-SACQ, which may be correlated with clinical activity. IL-6, an available cytokine, might be a potential biomarker for lupus activity evaluation in LLDAS subgroups. However, further validated studies are warranted to confirm our findings. <h3>REFERENCES:</h3> NIL.<b></b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>