AB1043 DAMAGE AND COMORBIDITIES PRESENT IN LUPUS PATIENTS FROM THE REGISTRY OF SYSTEMIC LUPUS ERYTHEMATOSUS OF THE SPANISH SOCIETY OF RHEUMATOLOGY (RELESSER)
Authors: J. M. Pego-Reigosa, A. Lois-Iglesias, Í. Rúa-Figueroa, M. Galindo-Izquierdo, J. Calvo Alén, V. Balboa-Barreiro, C. Mouriño, A. Olive, R. B. Melero González, A. Fernández-Nebro, M. Andrés, C. Erausquin, E. Tomero Muriel, C. Fito-Manteca, E. Uriarte Isacelaya, M. Freire González, C. Montilla, G. Santos Soler, A. Boteanu, E. Diez Alvarez, J. Narváez, V. Martinez Taboada, L. Silva-Fernández, M. Fernandez Castro, J. A. Hernandez Beriain, M. Gantes Mora, B. Hernández-Cruz, J. J. Pérez Venegas, A. Pecondon, G. Bonilla, V. Torrente Segarra, I. Castellví, J. J. Alegre Sancho, J. Calvet Fontova, J. L. Marenco, E. Raya Alvarez, T. Vazquez Rodriguez, V. Quevedo Vila, S. Muñoz Fernandez, T. Oton
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Life expectancy in systemic lupus erythematosus (SLE) increased but they can accrual another conditions associating higher morbidity and mortality than the general population. <h3>Objectives:</h3> To perform a descriptive analysis of the comorbidities present in a large SLE cohort, the accumulated damage, the distribution of events between sexes; the relationship between age at diagnosis, diagnostic delay and treatments administered to these patients. <h3>Methods:</h3> Multicenter cross-sectional study of RELESSER patients. Means were compared using the Mann-Whitney test after checking normality using the Kolmogorov-Smirnov test. Chi-square statistical test or Fisher's test, were used for qualitative items and Spearman's correlation coefficient for the correlation between quantitative variables. <h3>Results:</h3> We studied 3,656 patients, 90.3% women, mean age (±SD) at diagnosis of 35.2(±14.7) years and SLE duration of 142.6(±100.8) months. We analyzed 27 conditions (see Table 1, comorbidities from the Charlson comorbidity index and alcohol and tobacco consumption, autoimmune thyroid disease, dyslipidemia, arterial hypertension, pulmonary thromboembolism, hepatitis C virus infection, Sjögren, mixed connective tissue, fibromyalgia and osteoporosis). 79.73% of patients presented comorbidities: 24.97% presented one, followed by 2 (21.09%) or 3(15,48%) comorbidities. The most common were smoking, dyslipidemia and hypertension. In patients without comorbidities the first lupus criteria appeared earlier (27.73 (±12.04) vs. 34.47 (±14.76) years old, p&lt;0.001). They were younger at diagnosis: 29.42 (±12.13) vs. 36.62 (±14.91) years, p&lt;0.001) with a lower diagnostic delay (25.1(±43.21) vs.32.46(±55.53) months, p=0.085).Damage was present in 38,05% of patients (musculoskeletal 13,8%, ocular 8,51% and cardiovascular 7,99%). Mean Slicc Damage index was 1.2(±1.7). Males accumulated more damage (47.03% vs. 37.11%, p&lt;0.001) and more conditions (85.48% vs. 79.1%, p=0.003), specially: smoking, alcohol, mild liver disease, ischemic heart disease, chronic obstructive pulmonary disease, congestive heart failure, pulmonary embolism, peripheral arterial disease, and AIDS (p&lt;0.001). Fybromialgia and Sjögren where more frequent on women (p&lt;0.001). There was a positive correlation between the number of comorbidities and the number of systems with damage (Spearman's Rho = 0.478, p&lt;0.001, and between the number of comorbidities and damaged systems with the number of hospitalizations by disease activity (Rho=0.265 and 0.396 respectively, p&lt;0.001) and with the number of serious infections (Rho=0.299 and 0.307 respectively, p&lt;0.001), with a bigger damage accrual on the latter (1.97(±1.43) vs. 1.31(±0.61), p&lt;0.001). There were more patients without comorbidities in those who did never receive glucocorticoids(GC) (9.94% vs. 15.48%, p&lt;0.001), they accrual less conditions(1.46 (±1.43) vs. 2.27(±1.98). More patients had comorbidities from those who did not receive antimalarials (89.1% vs. 81.78%, p&lt;0.001), they also accumulated more: 2.94(±2.3) vs. 2.02(±1.82), p&lt;0.001. There were significant differences in the presence of comorbidities in those treated with cyclophosphamide, mycophenolate, azathioprine or rituximab. We did not find significant differences in patients treated with methotrexate, leflunomide, immunoglobulins, abatacept and anti-TNF. <h3>Conclusion:</h3> Nowadays SLE patients have a higher life expectancy. Comorbidities and damage accrual, with a few exceptions, were more frequent in males. There are differences in the presence of these conditions in patients with different treatments. <b>Table 1.</b> <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> RELESSER-TRANS was funded by GSK, Novartis, UCB and Roche. <h3>Disclosure of Interests:</h3> <b>None declared.</b>