Session Type: Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Up to 50% of patients with SLE develop irreversible organ damage within 10 years of diagnosis, and most experience recurrent disease flares of varying severity. Both the prevalence and severity of SLE are known to be higher in patients living in the Asia Pacific region, but few data on flare and damage rates are available. We examined the prevalence of organ damage and flare and estimated the magnitude of longitudinal associations between flares and subsequent organ damage accrual using real-world data from the Asia Pacific region.
Methods: Adult patients with SLE enrolled in a multinational cohort with a minimum of 3 years of observational data, captured prospectively between 2013 and 2020, were studied. Flares were assessed at each clinic visit using the Safety of Estrogens in Lupus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI). Flare Index and organ damage was assessed annually using SLICC/ACR Damage Index (SDI). Organ damage was defined as present if the SDI was greater than zero (SDI >0) while damage accrual was defined if the change in SDI was greater than zero (ΔSDI >0). Multivariable, multifailure survival analyses were carried out to quantify the association between flares and organ damage accrual.
Results: Overall, 1556 patients with SLE, recruited from Australia, China, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan and Thailand, and followed for a median (interquartile range) of 5.7 (3.9, 7.0) years were studied. The prevalence of organ damage at study enrollment (baseline) was 39% (n=614/1556) and the incidence of damage accrual during observation was ~58 per 1000 patient-years (PY) (n=496/8569.86 PY). 40% (n=247/614) of patients with baseline organ damage and 26% (n=249/942) of patients without baseline organ damage accrued damage during the study period. 74% (n=1153) of patients experienced a flare of any severity (mild/moderate or severe) at least once during the study period; 57% (n=885) experienced recurrent (≥2) flares. Flares independently increased the risk of damage accrual; after controlling for confounders, the risk of organ damage accrual at subsequent visits in patients who experienced any flare was 42% greater than in patients without flares (adjusted hazard ratio [HR] [95% confidence interval, CI]: 1.42 [1.17, 1.72]; Table). The risk of damage accrual was greater if patients had severe flares (HR [95% CI]: 1.52 [1.14, 2.03]). For each additional flare, the risk of damage accrual increased by 7% (HR [95% CI]: 1.07 [1.02, 1.13]).
Conclusion: The burden of organ damage and flares in SLE is substantial, and flares quantifiably increase the risk of damage accrual. Prevention of flares should be a major goal of SLE disease management to minimize permanent organ damage.
Funding: GSK (Study 217856)
To cite this abstract in AMA style:Kandane-Rathnayake R, Milea D, Louthrenoo W, Hoi A, Golder V, Cho J, Lateef A, Luo S, Wu Y, Hamijoyo L, Sockalingam S, Li Z, Navarra S, Zamora L, Harigai M, Katsumata Y, Chan M, Hao Y, Zhang Z, O’Neill S, Goldblatt F, Oon S, Xu X, Amador Navarro Rojas A, Bae S, Lau C, Nikpour M, Morand E. Burden of Flare and Organ Damage in Systemic Lupus Erythematosus (SLE) in the Asia Pacific Region: A Multicenter Cohort Study [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/burden-of-flare-and-organ-damage-in-systemic-lupus-erythematosus-sle-in-the-asia-pacific-region-a-multicenter-cohort-study/. Accessed .
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/burden-of-flare-and-organ-damage-in-systemic-lupus-erythematosus-sle-in-the-asia-pacific-region-a-multicenter-cohort-study/