Session Information
Date: Sunday, November 5, 2017
Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Homocysteine level is a predictor of the occurrence of cardiovascular diseases, however, its role as a predictor of damage in SLE has not been studied. The aim of this study is to determine the impact of homocysteine levels on damage accrual in SLE patients.
Methods:
These analyses were conducted in 145 SLE patient, 136 females and 9 males, followed longitudinally at a single center. Evaluations were done every six months and included interview, medical records review, physical examination and laboratory tests. Disease activity was measured with the SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). Damage accrual was ascertained with the SLICC/ACR damage index (SDI). Univariable and multivariable Cox regression models were performed to determine if homocysteine levels were associated with damage accrual. The multivariable model was adjusted for variables known to be associated with this outcome [age at diagnosis, gender, socioeconomic status, disease duration, SLEDAI, antimalarials and immunosuppressive drugs use, average daily dose and time of exposure to prednisone (PDN)].
Results:
The patients mean (SD) age at diagnosis was 43,70 (12,09) years, nearly all were Mestizo. At baseline, disease duration was 7,55 (6,73) years. The SLEDAI was 5,60 (4,34) and the SDI 0,97 (1,35). The average daily dose of PDN was 7,30 (5,78) mg/d and the time of exposure to PDN was 7,36 (6,73) years. Mean homocysteine levels was 10,07 (3.71) µmoles/liter. Patients were followed for 3.54 (1.27) years, and 75 (51.7%) increased at least one point in the SDI. Homocysteine level predicted new damage accrual in the univariable and multivariable models [HR 1.08 (CI95%: 1.03-1.14); p=0.002 and HR: 1.09 (CI95%: 1.02-1.16); p=0.008 respectively.]
|
Table. Homocysteine level as Predictor of Damage Accrual In SLE (multivariable analyses) |
|||
|
Variables |
HR |
95% CI |
p-value |
|
Homocysteine |
1,090 |
[1,023-1,162] |
0,008 |
|
Age at diagnosis, years |
1,025 |
[1,001-1,050] |
0,045 |
|
Disease duration, years |
1,058 |
[0,999-1,121] |
0,054 |
|
Gender (female) |
0,834 |
[0,292-2,380] |
0,734 |
|
Socioeconomic status |
|
|
|
|
High |
Ref. |
|
|
|
Medium status |
1,196 |
[0,602-2,378] |
0,609 |
|
Low status |
1,129 |
[0,634-2,011] |
0,681 |
|
SLEDAI, median |
1,026 |
[0,969-1,086] |
0,379 |
|
Immunosuppressive drugs use |
|
|
|
|
Never |
Ref. |
|
|
|
Past |
0,949 |
[0,456-1,975] |
0,888 |
|
Current |
1,474 |
[0,838-2,593] |
0,178 |
|
Hydroxychloroquine use |
|
|
|
|
Never |
Ref. |
|
|
|
Past |
0,782 |
[0,294-2,080] |
0,622 |
|
Current |
0,558 |
[0,266-1,172] |
0,124 |
|
Prednisone current dose (mg/d) |
0,995 |
[0,955-1,037] |
0,821 |
|
Time of exposure to prednisone, years |
1,000 |
[0,945-1,059] |
0,998 |
|
SDI |
0,867 |
[0,688-1,094] |
0,229 |
|
SDI SLICC/ACR damage index, SLEDAI systemic lupus erythematosus disease activity index |
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Conclusion:
Homocysteine levels in SLE patients predicted damage accrual independently of other well-known risk factors of damage.
To cite this abstract in AMA style:
Zeña-Huancas P, Ugarte-Gil M, Gamboa-Cárdenas R, Zevallos F, Medina M, Pimentel-Quiroz V, Elera-Fitzcarrald C, Sarmiento-Velasquez O, Reategui-Sokolova C, Cucho-Venegas M, Alfaro-Lozano J, Rodriguez-Bellido Z, Pastor-Asurza CA, Alarcón GS, Perich-Campos R. Homocysteine Levels Are Independently Associated with Damage Accrual in Systemic Lupus Erythematosus Patients (SLE) [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/homocysteine-levels-are-independently-associated-with-damage-accrual-in-systemic-lupus-erythematosus-patients-sle/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/homocysteine-levels-are-independently-associated-with-damage-accrual-in-systemic-lupus-erythematosus-patients-sle/