Antiphospholipid Syndrome (APS) in Systemic Lupus Erythematosus (SLE) Leads to a More Severe Disease

Leyre Riancho-Zarrabeitia¹, Víctor M Martinez-Taboada ², Iñigo Rua Figueroa ³, Fernando Alonso ⁴, María Galindo ⁵, Juan Ovalles-Bonilla ⁶, Alejandro Olivé-Marqués ⁷, Antonio Fernández-Nebro ⁸, Jaime Calvo-Alen ⁹, Raul Menor Almagro ¹⁰, Eva Tomero-Muriel ¹¹, Esther Uriarte Isacelaya ¹², Alina Boteanu ¹³, Mariano Andrés ¹⁴, Mercedes Freire González ¹⁵, Gregorio Santos Soler ¹⁶, Esther Ruiz Lucea ¹⁷, Monica Ibañez Barcelo ¹⁸, Ivan Castellvi ¹⁹, Carles Galisteo ²⁰, Víctor Quevedo Vila ²¹, Enrique Raya ²², Javier Narváez ²³, Lorena Expósito ²⁴, José A Hernández-Beriain ²⁵, Loreto Horcada Rubio ²⁶, Elena Aurrecoechea ²⁷ and Jose Maria Pego-Reigosa ²⁸, ¹Hospital Sierrallana, Torrelavega, Spain, ²Hospital Valdecilla, Santander, ³Hospital Doctor Negrin, Las Palmas, ⁴Unidad Investigación SER, Madrid, Spain, ⁵Hospital 12 De Octubre, Madrid, ⁶Hospital Gregorio Marañón, Madrid, Spain, ⁷Hospital German Trias i Pujol, Badalona, Spain, ⁸Hospital Carlos Haya, Malaga, Spain, ⁹Hospital Universitario Araba, Vitoria-Gasteiz, Spain, ¹⁰Hospital Universitario de Jerez, Puerto De Santa María, Spain, ¹¹Hospital Universitario La Princesa, Madrid, Spain, ¹²Hospital Universitario Donosti, San Sebastian, Spain, ¹³Hospital Universitario Ramón y Cajal, Madrid, Spain, ¹⁴Hospital General Universitario de Alicante, Alicante, Spain, ¹⁵Hospital Universitario Juan Canalejo, La Coruña, Spain, ¹⁶Hospital Marina Baixa, Villajoyosa, Spain, ¹⁷Hospital Universitario Basurto, Bilbao, Spain, ¹⁸Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain, ¹⁹Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, ²⁰Hospital Parc Taulí, Barcelona, Catalonia, Spain, ²¹Hospital Comarcal Monforte, Monforteº, Spain, ²²Hospital Universitario Clínico San Cecilio, Granada, Spain, ²³Rheumatology Department, Hospital Universitario de Bellvitge, Barcelona, Spain, Barcelona, Catalonia, Spain, ²⁴Hospital Universitario de Canarias, Las Palmas, Spain, ²⁵Hospital Insular Universitario de Gran Canaria, Las Palmas, Spain, ²⁶Complejo Hospitalario Universitario de Navarra, Pamplona, Spain, ²⁷Rheumatology Department. Hospital Sierrallana, Torrelavega, Spain, ²⁸Complexo Hospitalario Universitario, Vigo, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Antiphospholipid antibodies, Antiphospholipid syndrome and systemic lupus erythematosus (SLE)

Session Information

Date: Sunday, November 10, 2019

Title: SLE – Clinical Poster I: Epidemiology & Pathogenesis

Session Type: Poster Session (Sunday)

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

Background/Purpose: Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in SLE patients. Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS).

Methods: Patients from the RELESSER-T registry were included. RELESSER-T is a multicenter, hospital-based registry, with retrospective cross-sectional collection of data from a large representative sample of adult non-selected patients with SLE attending Spanish rheumatology services from the public national health system.

Results: We included 3651 SLE patients and 1368 were positive for aPL. Overall 2283 patients were classified as SLE no aPL, 552 as SLE-APS and 816 as SLE-aPL. Demographic data, clinical and laboratory features in the different groups are showed in Table 1. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes (p≤ 0.001). SLE-APS patients showed higher rates of neuropsychiatric, cardiac, pulmonary, renal and ophthalmological manifestations than the other groups (p< 0.001) (Table 1). In accordance with a more severe clinical profile, higher frequency of anti-DNA antibodies were observed in the SLE-APS group comparing with SLE (p< 0.001). SLE APS patients presented more damage accrual with higher values in SLICC (1.9±2.2 in SLE APS, 0.9±1.4 in SLE aPL and 1.1±1.6, p< 0.001) and Katz indexes (3±1.8 in SLE APS, 2.7±1.7 in SLE aPL and 2.6±1.6 in SLE no aPL, p < 0.001). In line with a more severe disease, mortality rate was higher in SLE APS patients (p< 0.001).

Conclusion: SLE-APS patients show a more severe clinical profile with higher frequency of major organ involvement and more damage accrual than SLE-aPL and SLE no APL

Table 1 ACR final

Table 1. Main clinical and demographic characteristics of the studied groups.

Disclosure: L. Riancho-Zarrabeitia, Abbvie, 8; V. Martinez-Taboada, None; I. Rua Figueroa, None; F. Alonso, None; M. Galindo, None; J. Ovalles-Bonilla, None; A. Olivé-Marqués, ND, 5, 8; A. Fernández-Nebro, None; J. Calvo-Alen, None; R. Menor Almagro, None; E. Tomero-Muriel, None; E. Uriarte Isacelaya, None; A. Boteanu, None; M. Andrés, None; M. Freire González, None; G. Santos Soler, None; E. Ruiz Lucea, None; M. Ibañez Barcelo, None; I. Castellvi, Actelion, 5, Boehringer -Ingelheim, 8, Gebro, 8, Kern, 5, Novartis, 8; C. Galisteo, None; V. Quevedo Vila, None; E. Raya, None; J. Narváez, None; L. Expósito, None; J. Hernández-Beriain, None; L. Horcada Rubio, None; E. Aurrecoechea, None; J. Pego-Reigosa, None.

To cite this abstract in AMA style:

Riancho-Zarrabeitia L, Martinez-Taboada V, Rua Figueroa I, Alonso F, Galindo M, Ovalles-Bonilla J, Olivé-Marqués A, Fernández-Nebro A, Calvo-Alen J, Menor Almagro R, Tomero-Muriel E, Uriarte Isacelaya E, Boteanu A, Andrés M, Freire González M, Santos Soler G, Ruiz Lucea E, Ibañez Barcelo M, Castellvi I, Galisteo C, Quevedo Vila V, Raya E, Narváez J, Expósito L, Hernández-Beriain J, Horcada Rubio L, Aurrecoechea E, Pego-Reigosa J. Antiphospholipid Syndrome (APS) in Systemic Lupus Erythematosus (SLE) Leads to a More Severe Disease [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/antiphospholipid-syndrome-aps-in-systemic-lupus-erythematosus-sle-leads-to-a-more-severe-disease/. Accessed .

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