AB1087 POSSIBILITY OF CLINICAL REMISSION AND LOW ACTIVITY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: REAL-LIFE STUDY
Authors: C. Raya-Santos, J. Rosas Gómez de Salazar, A. Pons-Bas, R. Gallego-Campuzano, J. C. Cortés-Quiroz, J. M. Senabre-Gallego, G. Santos Soler, L. Pons-Canet, J. A. Bernal
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Objectives:</h3> Analyze the characteristics of patients with SLE who achieve remission or low activity and determine its incidence in clinical practice. <h3>Methods:</h3> Retrospective cross-sectional study in patients undergoing follow-up for SLE. The following are collected: epidemiological data, comorbidities, cardiovascular risk factors (CVRF). For SLE: classification criteria score, year of diagnosis, form of onset, time of evolution, clinical data, presence of autoantibodies and level of C3 and C4, treatment received and dose of corticosteroids, immunosuppressants and biological therapy. The worst data for SLEDAI activity, cSLEDAI (does not include anti-DNA or C3, C4) and SLICC organ damage during follow-up and the last visit were analyzed. To define remission and low activity of SLE, the DORIS (Wilhelm TR. Ann Rheum Dis 2017) and EULAR 2023 (Fanouriakis A. Ann Rheum Dis 2023) criteria were used. The DORIS groups are included: Clinical remission; Complete remission; Clinical remission in treatment; Complete remission in treatment. In addition, the EULAR 2023 definition of Low activity and Remission. The physician's evaluation (PGA) has been excluded in DORIS because it is not available. The definitions are indicated in table 1. <h3>Results:</h3> 161 patients with SLE are included: 93% women, 56 (SD: 15) years of age, 39 (15) years at diagnosis and 15 (5) years of follow-up to date. The debut of SLE in &gt;3% of patients was: arthritis (27%), arthralgia and positive ANA (17%), cutaneous SLE (17%) and lupus nephropathy (10%), thrombopenia: 6%, hemolytic anemia 3.5%. CVRF: hypertension: 40%, hyperlipidemia: 32%, diabetes: 7%, AMI: 7%, smokers: 14%. 100% had ANA, anti-DNA: 97 (60%) patients, low C3-C4: 127 (79%), antiphospholipids: 68 (42%), 21 (13%) with triple positivity. 20% have presented thrombopenia and 6% have hemolytic anemia. The average score of the EULAR/ACR 2019 classification criteria: 18 (SD: 7). The worst average SLEDAI: 10 (SD: 5): 0: 41%, 1-4: 40%, &gt;4: 19%; neurological manifestations: 6%, headache: 5%, Stroke: 10%, myositis: 4%, vasculitis: 3%, renal: 24%, pleuro-pericarditis: 14%, osteonecrosis: 6%, fracture: 11%, mucocutaneous: 54%, arthritis: 77%. The current SLEDAI: 2 (2.5) and cSLEDAI: 1 (2). The mean SLICC: 0.6 (SD: 0.9); &gt;3%: musculoskeletal: 22 (14%), neoplasia: 15 (9%), neuropsychiatric: 15 (9%) and cardiovascular: 6%. Treatment received: hydroxychloroquine: 96%, methotrexate: 23%, leflunomide: 5%, azathioprine; 29%, mycophenolate: 18%, cyclophosphamide: 11%, rituximab; 4%, belimumab: 15%, anifrolumab: 1%, aspirin: 43%. anticoagulant: 13%. Although the current mean dose of prednisone is 8.75 (SD: 3.2) mg, 95 (59%) patients did not receive prednisone at the last visit. In the last 5 years, the average time since referral to Rheumatology of patients with suspected SLE is &lt;30 days. Table 1 shows the definition and results of patients who achieve remission and/or low activity, according to the DORIS and EULAR 2023 group. <h3>Conclusion:</h3> 1) 61% of the patients in our series with SLE debut due to arthralgia/arthritis or skin lesions. 2) In clinical practice, it is possible to achieve clinical remission, including complete and low activity. 3) In patients who achieve it, it is possible to withdraw corticosteroids and therefore reduce organic damage. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> The study was supported by a research grant from the Association for Research in Rheumatology of the Marina Baixa (AIRE-MB). <h3>Disclosure of Interests:</h3> <b>None declared.</b>