Factors Affecting Mortality of Systemic Lupus Erythematosus Patients in Spain in the 21st Century: Data from the RELESSER Registry

Clara Moriano¹, Jaime Calvo-Alén², Iñigo Rúa-Figueroa³, Elvira Díez Álvarez¹, Cristina Bermúdez⁴, Francisco J López-Longo⁵, Maria Galindo-Izquierdo⁶, Alejandro Olivé-Marqués⁷, Eva Tomero Muriel⁸, Antonio Fernandez-Nebro⁹, Mercedes Freire-González¹⁰, Olaia Fernandez-Berrizbeitia¹¹, Ana Pérez Gómez¹², Maria Esther Uriarte¹³, Carlos Marras Fernández-Cid¹⁴, Carlos Montilla Morales¹⁵, Gregorio Santos Soler¹⁶, Ricardo Blanco¹⁷, Manuel Rodríguez-Gómez¹⁸, Paloma Vela¹⁹, Alina Lucica Boteanu²⁰, Francisco Javier Narváez²¹, Victor Martinez Taboada²², Blanca Hernández Cruz²³, Jose Luis Andreu Sanchez²⁴, Jose A Hernández-Beriain²⁵, Lorena Expósito²⁶, Raul Menor Almagro²⁷, Mónica Ibañez-Barceló²⁸, Ivan Castellvi²⁹, Carlos Galisteo³⁰, Enrique Raya³¹, VE Quevedo-Vila³², Tomás Vázquez³³, J Ibáñez-Ruan³⁴ and Jose Maria Pego-Reigosa³⁵, ¹Complejo Asistencial Universitario de León, León, Spain, ²Hospital Universitario Araba, Vitoria-Gasteiz, Pais Vasco, Spain, ³Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain, ⁴Research Unit Bioaraba, Vitoria, Spain, ⁵Hospital General Universitario Gregorio Marañón, Madrid, Spain, ⁶Hospital Universitario 12 de Octubre, Madrid, Spain, ⁷Hospital Germans Trias i Pujol, Barcelona, Spain, ⁸Hospital Universitario de la Princesa, Madrid, Madrid, Spain, ⁹University of Malaga, Malaga, Spain, ¹⁰CHU Coruña, Coruña, Spain, ¹¹Basurto University Hospital, Bilbao, Spain, ¹²Hospital Universitario Príncipe Asturias, Alcalá de Henares, Madrid, Spain, ¹³Hospital Universitario Donostia, San Sebastian, Spain, ¹⁴Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ¹⁵Hospital Universitario de Salamanca, Salamanca, Spain, ¹⁶Hospital Marina Baixa, Alicante, Spain, ¹⁷Hospital Universitario Marques de Valdecilla, Santander, Spain, ¹⁸Hospital Complex of Ourense, Ourense, Spain, ¹⁹Hospital General Alicante, Alicante, Spain, ²⁰PRINTO, Istituto Giannina Gaslini, Genova, Italy, ²¹Hospital Bellvitge, BARCELONA, Spain, ²²Marqués de Valdecilla University Hospital, Santander, Spain, ²³Universidad de Sevilla, Sevilla, Spain, ²⁴Hospital Universitario Puerta de Hierro, Majadahonda, Spain, ²⁵Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain, ²⁶Hospital Clinico Tenerife, Tenerife, Spain, ²⁷Hospital General Universitario de Jerez de la Frontera, Puerto De Santa Mar�a, Spain, ²⁸Hospital Son Llatzer, Mallorca, Spain, ²⁹Hospital Santa Creu i Sant Pau, Barcelona, Spain, ³⁰Hospital Parc Taulí, Barcelona, Spain, ³¹Hospital San Cecilio, Granada, Spain, ³²Hospital Comarcal de Monforte, Lugo, Spain, ³³Hospital Lucus Augusti, Lugo, Spain, ³⁴Hospital Povisa, Vigo, Pontevedra, Spain, ³⁵University Hospital of Vigo, Galicia Sur Health Research Institute, Vigo, Spain

Meeting: ACR Convergence 2020

Keywords: Mortality, registry, Systemic lupus erythematosus (SLE)

Session Information

Date: Sunday, November 8, 2020

Title: SLE – Diagnosis, Manifestations, & Outcomes Poster II: Comorbidities

Session Type: Poster Session C

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

Background/Purpose: The mortality in Systemic Lupus Erythematosus (SLE) varies largely across different countries most probably due to social, healthcare and ethnic differences.
To analyze the causes and identify predictive factors of mortality of SLE in Spain in the present century.

Methods: We performed a cross-sectional and retrospective study analyzing data from the RELESSER cohort (Spanish Registry of Systemic Lupus Erythematosus of the Spanish Society of Rheumatology). We included all patients diagnosed with SLE since the year 2000 and recorded sociodemographic, clinical and serological variables, comorbidities and treatments, as well as indicators of disease activity, damage and severity. The characteristics of the deceased patients were compared with those of the survivors, and variables with clinical significance or statistical significance were grouped into multivariate models to determine which ones were independently associated with the outcome of the disease.

Results: A total of 2004 patients were included, 88.6% female, the mean age at diagnosis was 38.3 (+ 15.3) years, with a mean delay in diagnosis of 28.9 (+ 52.6) months. Up to 2.84% of the individuals had died. The leading cause of death was SLE activity (n=16), followed by infections (n=14), vascular events (n=12) and cancer (n=6). The mean age of death was 54.68 (+ 20.13) years, and neither age, sex nor delay in diagnosis was independently associated with mortality. The presence of nephritis, depression, severe infections, organ damage (SLICC/ACR DI) or disease activity (SLEDAI), as well as the use of cyclophosphamide, rituximab or high doses of corticosteroids, were predictors of mortality in our cohort. Antimalarial treatment and skin manifestations were linked to improved survival.

Conclusion: In the RELESSER cohort, clinical factors, co-morbidities, as well as therapeutic attitudes were associated with a significant increase in mortality in SLE. Interestingly, depression was independently associated to mortality. The activity of the disease and infections continue to be the main causes of death at the beginning of the 21st century amongst our patients.

Table 1. Summary Multivariate Statistical Analysis

Disclosure: C. Moriano, None; J. Calvo-Alén, None; I. Rúa-Figueroa, None; E. Díez Álvarez, None; C. Bermúdez, None; F. López-Longo, None; M. Galindo-Izquierdo, None; A. Olivé-Marqués, None; E. Tomero Muriel, None; A. Fernandez-Nebro, Roche, 1, Nordic, 1, Stada, 1, Sanofi, 1, Janssen, 1, Pfizer, 1, Abbvie, 1, Novartis, 1, Gedeon, 1, Lilly, 1; M. Freire-González, None; O. Fernandez-Berrizbeitia, None; A. Pérez Gómez, None; M. Uriarte, None; C. Marras Fernández-Cid, None; C. Montilla Morales, None; G. Santos Soler, None; R. Blanco, None; M. Rodríguez-Gómez, None; P. Vela, None; A. Boteanu, AbbVie, 8, Novartis, 8, Roche, 8; F. Narváez, None; V. Martinez Taboada, None; B. Hernández Cruz, None; J. Andreu Sanchez, None; J. Hernández-Beriain, None; L. Expósito, None; R. Menor Almagro, None; M. Ibañez-Barceló, None; I. Castellvi, None; C. Galisteo, None; E. Raya, None; V. Quevedo-Vila, None; T. Vázquez, None; J. Ibáñez-Ruan, None; J. Pego-Reigosa, None.

To cite this abstract in AMA style:

Moriano C, Calvo-Alén J, Rúa-Figueroa I, Díez Álvarez E, Bermúdez C, López-Longo F, Galindo-Izquierdo M, Olivé-Marqués A, Tomero Muriel E, Fernandez-Nebro A, Freire-González M, Fernandez-Berrizbeitia O, Pérez Gómez A, Uriarte M, Marras Fernández-Cid C, Montilla Morales C, Santos Soler G, Blanco R, Rodríguez-Gómez M, Vela P, Boteanu A, Narváez F, Martinez Taboada V, Hernández Cruz B, Andreu Sanchez J, Hernández-Beriain J, Expósito L, Menor Almagro R, Ibañez-Barceló M, Castellvi I, Galisteo C, Raya E, Quevedo-Vila V, Vázquez T, Ibáñez-Ruan J, Pego-Reigosa J. Factors Affecting Mortality of Systemic Lupus Erythematosus Patients in Spain in the 21st Century: Data from the RELESSER Registry [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/factors-affecting-mortality-of-systemic-lupus-erythematosus-patients-in-spain-in-the-21st-century-data-from-the-relesser-registry/. Accessed .

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