ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2667

Sledai and Mex-Sledai Glucocorticoid Indices As Predictors of Damage and Mortality in Multinational Multiethnic Latin American Cohort

Manuel Ugarte-Gil1,2, Ines Segami3,4, Guillermina Harvey5, Guillermo J. Pons-Estel6, Rosana Quintana7, Cristina Reategui-Sokolova8, Jorge Cieza4, Luis J. Catoggio9, Mercedes Garcia10, Verónica Saurit11, Francisco Caeiro12, Cristina Drenkard13, Guillermo Berbotto14, Emilia Sato15, Lilian Costallat16, Eloisa Bonfa17, Joao C. Tavares Brenol18, Nilzio A Da Silva19, Fernando Cavalcanti20, Antonio Iglesias-Gamarra21, Marlene Guibert-Toledano22, Gil A. Reyes22, Loreto Massardo23, Oscar J Neira24, Mario H Cardiel25, Leonor Barile26, Mary Carmen Amigo27, Luis H. Silveira28, Ignacio Garcia de la Torre29, Eduardo Acevedo-Vasquez2, Rosa Chacón-Díaz30, Maria H Esteva Spinetti31, Graciela S. Alarcón32,33 and Bernardo A Pons-Estel7, 1Rheumatology, Universidad Científica del Sur, Lima, Peru, 2Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, 3Universidad Nacional Mayor de San Marcos, Lima, Peru, 4Hospital Edgardo Rebagliati Martins. EsSalud, Lima, Peru, 5Escuela de Estadística, Universidad Nacional de Rosario, Rosario, Argentina, 6Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario. Argentina, Rosario, Argentina, 7Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Rosario, Argentina, 8Rheumatology, Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, 9Rheumatology Unit, Internal Medicine Service. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina, 10Rheumatology, HIGA General San Martin La Plata, La Plata, Argentina, 11Hospital Privado Centro Médico de Córdoba, Cordoba, Argentina, 12Rheumatology, Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina, 13Medicine/Rheumatology, Emory University, Atlanta, GA, 14Hospital Escuela Eva Perón, Granadero Baigorria, Argentina, Granadero Baigorria, Argentina, 15Rheumatology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil, 16Universidade Estadual da Campinas, Campinas, Brazil, 17Rheumatology Division, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, 18Hospital da Clinicas da Porto Alegre, Porto Alegre, Brazil, 19Faculdade de Medicina da Universidade Federal de Goiás, Goiania, Brazil, 20Universidade Federal da Pernambuco, Pernambuco, Brazil, 21Universidad Nacional de Colombia, Bogota, Colombia, 22Centro de Investigaciones Médico-Quirúrgicas (CIMEQ), Havana, Cuba, 23Centro de Biología Celular y Biomedicina (CEBICEM), Universidad San Sebastián, Santiago, Chile, 24Hospital del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile, 25Centro de Investigación Clínica de Morelia, Morelia, Mexico, 26Hospital Ángeles del Pedregal, Mexico, Mexico, 27Rheumatology, Centro Medico ABC, Mexico, Mexico, 28Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City DF, Mexico, 29Hospital General de Occidente, Guadalajara, Mexico, 30Servicio de Reumatología, Hospital Universitario de Caracas, Centro Nacional de Enfermedades Reumáticas, Caracas, Venezuela, 31Hospital Central de San Cristóbal, San Cristobal, Venezuela (Bolivarian Republic of), 32Universidad Peruana Cayetano Heredia, Lima, Peru, 33Department of Medicine, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Tuesday, October 23, 2018

Title: Systemic Lupus Erythematosus – Clinical Poster III: Treatment

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Disease activity is one of the major predictors of damage accrual and mortality in systemic lupus erythematosus (SLE). Glucocorticoid use, especially in high dose, could underestimate the inflammatory status in SLE patients. Based on that, a modification of the SLEDAI accounting for glucocorticoid dose has been proposed, the SLEDAI glucocorticoid index (SGI)1. The aim of this study is to evaluate the impact of SGI and Mex-SLEDAI GI (M-SGI) as predictors of damage and mortality.

 

Methods: Patients from a multinational, multiethnic Latin American cohort were included in these analyses. SGI was calculated based on the impact of glucocorticoids proposed by the Toronto Cohort1. The same value for the impact of glucocorticoid was used for developing an M-SGI. Damage accrual was evaluated using the SLICC/ACR damage index (SDI). To evaluate the impact of SGI and M-SGI on the first increase on damage and on mortality, Cox regression models were performed, adjusting for gender, age at diagnosis, ethnicity, medical coverage, place of residence, educational level, SDI at baseline and antimalarial, glucocorticoid and immunosuppressive drugs use before baseline. Similar models were applied for the SLEDAI and the Mex-SLEDAI. All confounders were evaluated at or before baseline, and disease activity indices were evaluated as a time-dependent variable.

 

Results: One thousand three-hundred and twenty-one patients were included, median (25th-75th) age at diagnosis was 27.0 (20.0-37.0) years, 582 (44.1%) were Mestizo, 532 (40.3%) Caucasian, and 207 (15.7%) other. Median SLEDAI was 4 (0-12), Mex-SLEDAI was 3 (0-6), SGI was 7 (4-12) and M-SGI was 5 (2-9). Median follow-up was 4.3 (2.1-5.9) years. During follow up, sixty-nine patients (5.2%) died and 323 (24.5%) accrued new damage. The median values for the disease activity indices as a function of damage and mortality are depicted in Table 1. The corresponding hazard ratios are depicted in Table 2.

 

Conclusion: SGI and M-SGI predicted new damage and mortality in SLE patients independently of other well-known risk factors. However, their impact seems to be similar to those of the original versions of these instruments.

References

1. Touma Z, Gladman D, Su J, Urowitz M. 11 Development and initial validation of a novel lupus disease activity index to account for glucocorticoids: SLEDAI-2K glucocorticoids index (SGI). Lupus Sci Med 2017;4 :doi: 10.1136/lupus-2017-000215.11

 

Disclosure: M. Ugarte-Gil, None; I. Segami, None; G. Harvey, None; G. J. Pons-Estel, None; R. Quintana, None; C. Reategui-Sokolova, None; J. Cieza, None; L. J. Catoggio, None; M. Garcia, None; V. Saurit, None; F. Caeiro, None; C. Drenkard, ILAR, 2,PANLAR, 2; G. Berbotto, None; E. Sato, None; L. Costallat, None; E. Bonfa, Fundação de Amparo à Pesquisa do Estado de São Paulo, 2,Conselho Nacional de Desenvolvimento Científico e Tecnológico, 2; J. C. Tavares Brenol, None; N. A. Da Silva, None; F. Cavalcanti, None; A. Iglesias-Gamarra, None; M. Guibert-Toledano, None; G. A. Reyes, None; L. Massardo, None; O. J. Neira, None; M. H. Cardiel, Gilead, Pfizer Inc, Roche, 2,Eli Lilly, Pfizer Inc, 5,Eli Lilly, Pfizer Inc, 8; L. Barile, None; M. C. Amigo, None; L. H. Silveira, None; I. Garcia de la Torre, None; E. Acevedo-Vasquez, None; R. Chacón-Díaz, None; M. H. Esteva Spinetti, None; G. S. Alarcón, None; B. A. Pons-Estel, None.

To cite this abstract in AMA style:

Ugarte-Gil M, Segami I, Harvey G, Pons-Estel GJ, Quintana R, Reategui-Sokolova C, Cieza J, Catoggio LJ, Garcia M, Saurit V, Caeiro F, Drenkard C, Berbotto G, Sato E, Costallat L, Bonfa E, Tavares Brenol JC, Da Silva NA, Cavalcanti F, Iglesias-Gamarra A, Guibert-Toledano M, Reyes GA, Massardo L, Neira OJ, Cardiel MH, Barile L, Amigo MC, Silveira LH, Garcia de la Torre I, Acevedo-Vasquez E, Chacón-Díaz R, Esteva Spinetti MH, Alarcón GS, Pons-Estel BA. Sledai and Mex-Sledai Glucocorticoid Indices As Predictors of Damage and Mortality in Multinational Multiethnic Latin American Cohort [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/sledai-and-mex-sledai-glucocorticoid-indices-as-predictors-of-damage-and-mortality-in-multinational-multiethnic-latin-american-cohort/. Accessed .

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