ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1422

Clinical Associations of Anti-Smith Antibodies in Profile: A Multiethnic Lupus Cohort

Yesenia C. Santiago-Casas1, Luis M. Vila1, Gerald McGwin Jr.2, Ryan S. Cantor2, Michelle Petri3, Rosalind Ramsey-Goldman4, John D. Reveille5, Robert P. Kimberly6, Graciela S. Alarcon7 and Elizabeth E. Brown8, 1Department of Medicine, Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, PR, 2Epidemiology, University of Alabama at Birmingham, Birmingham, AL, 3Johns Hopkins University School of Medicine, Baltimore, MD, 4Medicine/Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, 5Internal Medicine/Rheumatology, Univ of Texas Health Science Center at Houston, Houston, TX, 6Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 7Medicine, University of Alabama at Birmingham, Birmingham, AL, 8University of Alabama at Birmingham, Birmingham, AL

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Systemic Lupus Erythematosus: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose: Anti-Smith (anti-Sm) antibodies are highly specific for systemic lupus erythematosus (SLE) and have an important value in the diagnosis of this disease.  However, whether these autoantibodies are associated to a specific subset of clinical manifestations or if they convey a prognostic value in lupus remains controversial.  The aim of this study was to determine the association between anti-Sm antibodies and clinical manifestations, comorbidities, and disease damage in a large multiethnic SLE cohort.

Methods: SLE patients (per ACR criteria), age ≥ 16 years, disease duration ≤ 10 years at enrollment, and defined ethnicity (African American, Hispanic or Caucasian), from a longitudinal cohort were studied. Socioeconomic-demographic features, cumulative clinical manifestations, comorbidities, and disease damage [as per the Systemic Lupus International Collaborating Clinics Damage Index (SDI)] were determined.  The association of the anti-Sm antibodies with clinical features was examined using multivariable logistic regression adjusting for age, gender, race/ethnicity, disease duration, education, smoking, and type of medical insurance.

Results: A total of 2,322 SLE patients were studied.  The mean (standard deviation, SD) age at diagnosis was 34.4 (12.8) years and the mean (SD) disease duration was 9.0 (7.9) years; 2,127 (91.6%) were women. Anti-Sm antibodies were present in 579 (24.9%) patients.  In the multivariable analysis, SLE patients with anti-Sm antibodies were more likely to have serositis (odds ratio [OR] 1.51, 95% confidence interval [95% CI] 1.23-1.84), renal involvement (OR 1.33, 95% CI 1.08-1.64), neurologic involvement (OR 1.51, 95% CI 1.12-2.04), psychosis (OR 1.60, 95% CI 1.01-2.53), vasculitis (OR 1.50, 95% CI 1.17-1.94), Raynaud’s phenomenon (OR 1.64, 95% CI 1.34-2.00), hemolytic anemia (OR 1.73, 95% CI 1.28-2.35), leukopenia (OR 1.56, 95% CI 1.28-1.91), lymphopenia (OR 1.76, 95% CI 1.43-2.16), and arterial hypertension (OR 1.32, 95% CI 1.07-1.62). No significant associations were found for mucocutaneous manifestations and damage accrual. 

Conclusion: In this cohort of SLE patients, anti-Sm antibodies were associated with several clinical features including serious manifestations such as renal disease, neurologic involvement, hemolytic anemia and vasculitis.

Disclosure:

Y. C. Santiago-Casas,
None;

L. M. Vila,
None;

G. McGwin Jr.,
None;

R. S. Cantor,
None;

M. Petri,
None;

R. Ramsey-Goldman,
None;

J. D. Reveille,
None;

R. P. Kimberly,
None;

G. S. Alarcon,
None;

E. E. Brown,
None.

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