Cluster Analysis of Autoantibodies in Patients with Systemic Lupus Erythematosus

Oihane Ibarguengoitia-Barrena¹, Leyre Riancho Zarrabeitia², Iñigo Rúa-Figueroa³, Karen Roberts⁴, Victor Martinez-Taboada⁵, Raúl Menor Almagro⁶, Belén Serrano-Benavente⁷, Paula Rubio-Muñoz⁸, María Galindo-Izquierdo⁹, Antonio Fernández-Nebro¹⁰, Maria Esther Ruiz Lucea¹¹, Jaime Calvo¹², Jose Francisco Garcia Llorente¹³, EVA GLORIA TOMERO MURIEL¹⁴, Maria Esther Uriarte¹⁵, Mercedes Freire González¹⁶, Angela Pecondón-Español¹⁷, Javier García-Fernández¹⁸, Lorena Expósito-Pérez¹⁹, Monica Ibañez Barcelo²⁰, Elena Aurrecoechea²¹, Carlos Montilla²², Jose Rosas Gómez de Salazar²³, Maria Garcia-Villanueva²⁴, Rocío Caño²⁵, Francisco Javier Toyos²⁶, Francisco Javier Novoa²⁷, Clara Moriano²⁸, Gema Bonilla²⁹, Javier Narváez³⁰, Jose Luis Andreu³¹, Marta Arévalo-Salaet³², Loreto Horacda-Rubio³³, Tatiana Cobo-Ibáñez³⁴, Nuria Lozano Rivas³⁵, Cristina Bohorquez³⁶, Carlota Laura Iniguez Ubiaga³⁷, Eva salgado-Pérez³⁸, Vicente Torrente Segarra³⁹, CARLOS TAREK SALMAN MONTE⁴⁰, JOSE ELOY OLLER RODRIGUEZ⁴¹ and José María Pego-Reigosa⁴², ¹Galdakao-Usansolo University Hospital, Bilbao, Spain, ²Hospital Sierrallana, Santander, Spain, ³Hospital de Gran Canaria Doctor Negrin, Las Palmas GC, Spain, ⁴Buenos Aires Instituto, West Reading, CA, ⁵Facultad de Medicina. Universidad de Cantabria, Santander, Spain, ⁶Department of Rheumatology, Hospital de Jerez, Spain, Puerto De Santa María, Spain, ⁷Hospital Gregorio Marañon, Madrid, Spain, ⁸Hospital Germans Trias i Pujol, Badalona, Spain, ⁹Department of Rheumatology, Hospital Universitario ¹² de Octubre, Madrid, Spain, Madrid, Madrid, Spain, ¹⁰Hospital Regional Universitario de Malaga, Malaga, Spain, Malaga, Spain, ¹¹Basurto University Hospital, Bilbao, Spain, ¹²Department of Rheumatology, Hospital Universitario Araba, School of Medicne, Universidad del País Vasco, BIOARABA Health Research Institute, Vitoria, Spain, Vitoria, Pais Vasco, Spain, ¹³Hospital de Gadakao Usansolo Osakidetza, Bilbao, Spain, ¹⁴Hospital Universitario de la Princesa, Madrid, Spain, ¹⁵Hospital Universitario Donostia, San Sebastian, Spain, ¹⁶⁴ Hospital Universitario A Coruña, Rheumatology, A Coruña, La coruna, Spain, ¹⁷Hospital Universitario Miguel Servet, Zaragoza, Spain, ¹⁸Hospital Universitario Marqués de Valdecilla, Santander, Spain, ¹⁹University Clinical Hospital of Canarias, Tenerife, Spain, ²⁰Son Llàtzer University Hospital, Palma de Mallorca, Spain, ²¹Hospital Sierrallana, CANTABRIA, Spain, ²²Rheumatology Service, University Hospital of Salamanca, Salamanca, Castilla y Leon, Spain, ²³Hospital Marina Baixa, PALMA DE MALLORCA, Spain, ²⁴Hospital Ramón y Cajal, Madrid, Spain, ²⁵Rheumatology Department, Dr. Balmis General University Hospital, Alicante, Spain., Alicante, Spain, ²⁶Virgen Macarena University Hospital,, Sevilla, Spain, ²⁷Hospital Insular de Gran Canaria, Las palmas, ²⁸Hospital León, LEON, Castilla y Leon, Spain, ²⁹Hospital Universitario La Paz, Rheumatology, Madrid, Madrid, Spain, ³⁰Hospital Universitario de Bellvitge, Barcelona, Spain, ³¹Hospital Universitario Puerta de Hierro, Majadahonda, Spain, ³²Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain, ³³Hospital Complex of Navarra, Pamplona, Spain, ³⁴Infanta Sofia Hospital, Madrid, Spain, ³⁵Hospital Clínico Universitario Virgen de la Arrixaca,, Murcia, Spain, ³⁶La Paz University Hospital, Alcalá De Henares, Spain, ³⁷SERV. REUMATOLOGIA, Lugo, Spain, ³⁸Complejo Hospitalario de Orense, Santiago de Composte, Spain, ³⁹Hospital Comarcal del Alt Penedes, Madrid, Spain, ⁴⁰Hospital del Mar, Barcelona, Spain, ⁴¹HOSPITAL UNIVERSITARI I POLITÈCNIC LA FE, VALENCIA, Spain, ⁴²Department of Rheumatology, University Hospital of Vigo, Vigo, Spain; IRIDIS Group (Investigation in Rheumatology and Immune-Diseases), Galicia Sur Health Research Institute, Vigo, Spain

Meeting: ACR Convergence 2025

Keywords: Autoantibody(ies), Comorbidity, Damage Index, Disease Activity, Systemic lupus erythematosus (SLE)

Session Information

Date: Tuesday, October 28, 2025

Title: (2377–2436) Systemic Lupus Erythematosus – Diagnosis, Manifestations, & Outcomes Poster III

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder characterized by multi-organ involvement and variable clinical manifestations. Recurrent clinical patterns suggest distinct phenotypes, where cluster analysis of autoantibodies could identify prognostic subtypes. The objective of this study is to define and describe serological clusters and their clinical-epidemiological characteristics, as well as their association with comorbidities, disease activity measures, severity, and damage.

Methods: Descriptive, observational, and multicenter study including SLE patients from the Spanish Registry RELESSER (includes a cross-sectional phase and a prospective phase with annual visits over four consecutive years). Gower distance was used for cluster analysis.

Results: A total of 1,740 patients from the cross-sectional phase and 718 from the prospective phase were included. Four serological clusters were identified. Cluster 1 ((negative for extractable nuclear antigen); 44.5% of the patients) was characterized by lower frequency of vasculitis (6.6%), leukopenia (49.1%) and lymphopenia (48.0%). Cluster 2 (positive antiphospholipid antibodies; 12.24%) was represented by higher frequency of high blood pressure (35.5%) as well as hemolytic anemia (13.5%), thrombocytopenia (39.9%), vasculitis (12.5%), visual disturbances (9.1%) and higher use of immunoglobulins (10.3%) and oral anticoagulants (39.0%). Cluster 3 (positive anti-Ro/anti-La; 26.7%) had the lowest frequency of lupus nephritis (24.9%). Patients from cluster 4 (positive anti-Sm/anti-RNP; 16.55%) were younger at disease onset (median age of 29.2 years) and had the highest frequency of lupus nephritis (38.5%), leukopenia (66.0%), lymphopenia (62.2%), hypocomplementemia (89.5%), myositis (5.6%) and cutaneous manifestations. Besides, they had a higher frequency of osteoporosis (11.0%) and severe infections (26.4%) and a higher use of glucocorticoids (93.5%), azathioprine (42.0%), cyclophosphamide (25.5%) and mycophenolate mofetil (24.0%). Regarding disease activity assesed by SLEDAI (Systemic Lupus Erythematosus Disease Activity Index), at visit 1 of the prospective phase, patients in cluster 4 had the highest scores: 2.5 ± 3.4. After 4 years of follow-up, no differences were observed between clusters. Concerning damage assessed by SLICC/ACR DI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), patients in cluster 2 exhibited the highest scores at visit 1: 1.9 ± 2.3. After 4 years of follow-up, a significant increase was observed across all clusters (p< 0.001), with differences between clusters persisting at the end (p=0.049). Regarding severity (Katz index), patients in cluster 4 had the highest scores at visit 1: 5.2 ± 2.0. The differences persisted after follow-up (p=0.005). As for mortality, 21 deaths were recorded: 5 in cluster 1 (1.7%), 6 in cluster 2 (5.5%), 6 in cluster 3 (2.9%) and 4 in cluster 4 (3.3%), with no significant differences between clusters (p=0.427).

Conclusion: In our cohort, the serological profile constitutes a crucial factor for the clinical stratification of patients and predicting their prognosis.

Disclosures: O. Ibarguengoitia-Barrena: None; L. Riancho Zarrabeitia: None; I. Rúa-Figueroa: None; K. Roberts: None; V. Martinez-Taboada: None; R. Menor Almagro: None; B. Serrano-Benavente: None; P. Rubio-Muñoz: None; M. Galindo-Izquierdo: None; A. Fernández-Nebro: Argenx, 5, AstraZeneca, 2, 5, 6, Chemo, 5, Eli Lilly, 2, 6, Galapagos, 2, 5, 6, Gebro Pharma, 2, 6, GlaxoSmithKline (GSK), 2, 6, Johnson & Johnson, 5, Merck Serono, 5, MSD, 5, Novartis, 2, 5, 6, Takeda, 5, UCB, 5; M. Ruiz Lucea: None; J. Calvo: None; J. Garcia Llorente: None; E. TOMERO MURIEL: None; M. Uriarte: None; M. Freire González: None; A. Pecondón-Español: None; J. García-Fernández: None; L. Expósito-Pérez: None; M. Ibañez Barcelo: None; E. Aurrecoechea: None; C. Montilla: None; J. Rosas Gómez de Salazar: None; M. Garcia-Villanueva: None; R. Caño: None; F. Toyos: None; F. Novoa: None; C. Moriano: None; G. Bonilla: None; J. Narváez: None; J. Andreu: None; M. Arévalo-Salaet: None; L. Horacda-Rubio: None; T. Cobo-Ibáñez: None; N. Lozano Rivas: None; C. Bohorquez: None; C. Iniguez Ubiaga: None; E. salgado-Pérez: None; V. Torrente Segarra: None; C. SALMAN MONTE: None; J. OLLER RODRIGUEZ: None; J. Pego-Reigosa: AstraZeneca, 1, 5, 6, GlaxoSmithKline (GSK), 1, 5, 6, Otsuka, 1, 6.

To cite this abstract in AMA style:

Ibarguengoitia-Barrena O, Riancho Zarrabeitia L, Rúa-Figueroa I, Roberts K, Martinez-Taboada V, Menor Almagro R, Serrano-Benavente B, Rubio-Muñoz P, Galindo-Izquierdo M, Fernández-Nebro A, Ruiz Lucea M, Calvo J, Garcia Llorente J, TOMERO MURIEL E, Uriarte M, Freire González M, Pecondón-Español A, García-Fernández J, Expósito-Pérez L, Ibañez Barcelo M, Aurrecoechea E, Montilla C, Rosas Gómez de Salazar J, Garcia-Villanueva M, Caño R, Toyos F, Novoa F, Moriano C, Bonilla G, Narváez J, Andreu J, Arévalo-Salaet M, Horacda-Rubio L, Cobo-Ibáñez T, Lozano Rivas N, Bohorquez C, Iniguez Ubiaga C, salgado-Pérez E, Torrente Segarra V, SALMAN MONTE C, OLLER RODRIGUEZ J, Pego-Reigosa J. Cluster Analysis of Autoantibodies in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/cluster-analysis-of-autoantibodies-in-patients-with-systemic-lupus-erythematosus/. Accessed .

« Back to ACR Convergence 2025

ACR Meeting Abstracts - https://acrabstracts.org/abstract/cluster-analysis-of-autoantibodies-in-patients-with-systemic-lupus-erythematosus/