AB1094 PREDICTIVE FACTORS OF RESPONSE TO MYCOPHENOLATE MOFETIL TREATMENT IN A SINGLE-CENTER COHORT OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: A. Milone, C. Parlati, M. Patrone, F. Riccio, M. Annunziata, M. Brancaccio, M. L. Marchesano, S. Fasano, D. Mauro, F. Ciccia, G. Cuomo
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic Lupus Erythematosus (SLE) is a complex disease, whose therapeutic options remain limited to treat the multisystem characteristics of the disease. <h3>Objectives:</h3> to evaluate the presence of predictive factors of response to treatment with Mycophenolate Mofetil in patients with Systemic Lupus Erythematosus through a retrospective analysis of data from a single-center cohort. <h3>Methods:</h3> clinical-epidemiological data of SLE patients treated with Mycophenolate Mofetil were evaluated. Treatment efficacy at 3 and 6 months after initiation of therapy was evaluated using SLEDAI-2K. Age, sex, BMI, disease duration, ESR value, and anti-ds DNA positivity before starting treatment were analyzed in relation to the SLEDAI-2k at 3 and 6 months after initiation of Mycophenolate Mofetil therapy. This analysis made it possible to assess the possible presence of predictive factors of response in the first months of therapy, through the use of Spearman's R correlation index for ranks. <h3>Results:</h3> We analyzed data from 74 patients treated with Mycophenolate Mofetil in our cohort, consisting of: 67 females (90.54 %), 7 males (9.45 %); mean age 43 years (± 9.7), median 43.5 (21-69). The clinical manifestations for which they started treatment were: renal, mucocutaneous, hematologic, neuropsychiatric, articular, and serositic manifestations. Mean disease duration was 16.4 years (± 10), median 14 (1-40). SLEDAI-2K value at T0 was 10.5 (± 4.2), median 10.5 (2-24); at T3 6.9 (± 3.1), median 7.5 (0-16); at T6 4.3 (±3), median 4 (0-16). Retrospective data analysis demonstrated a greater response to treatment in patients who had a lower BMI at the start of therapy; this finding was statistically significant at 3 months of treatment and tended toward significance at 6 months. Longer disease duration is associated with a response to treatment that is directly proportional to it; this finding is confirmed to be statistically significant at both 3 and 6 months after the start of treatment. In addition, higher ESR levels and anti-ds DNA positivity at diagnosis are associated with a greater reduction in SLEDAI-2K at 3 months after treatment initiation, an effect not confirmed at 6 months. The reduction in SLEDAI-2K does not correlate with the age and sex of patients. <h3>Conclusion:</h3> In our cohort of SLE patients, lower BMI value, higher ESR values and anti-ds DNA positivity at the start of treatment, duration of disease, are associated with a greater reduction in SLEDAI-2K three months after the start of Mycophenolate Mofetil therapy. These response predictors demonstrate rapid treatment efficacy over months of therapy in patients with these characteristics. Knowing the clinical characteristics and/or biomarkers allows us to predict the outcome of patients. <h3>REFERENCES:</h3> [1] Dall'Era M, Stone D, Levesque V, Cisternas M, Wofsy D. Identification of biomarkers that predict response to treatment of lupus nephritis with mycophenolate mofetil or pulse cyclophosphamide. Arthritis Care Res (Hoboken). 2011 Mar;63(3):351-7 <b>Table 1.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>