ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 687

Homocysteine Levels Are Independently Associated with Damage Accrual in Systemic Lupus Erythematosus Patients (SLE)

Paola Zeña-Huancas1, Manuel Ugarte-Gil2,3, Rocío Gamboa-Cárdenas1, Francisco Zevallos1, Mariela Medina1, Victor Pimentel-Quiroz2, Claudia Elera-Fitzcarrald1, Omar Sarmiento-Velasquez1, Cristina Reategui-Sokolova1, Mariano Cucho-Venegas1, José Alfaro-Lozano1, Zoila Rodriguez-Bellido1,4, Cesar A. Pastor-Asurza1,4, Graciela S. Alarcón5 and Risto Perich-Campos4,6, 1Rheumatology, Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, 2Peru, GLADEL, Lima, Peru, 3Universidad Cientifica del Sur, Lima, Peru, 4Universidad Nacional Mayor de San Marcos, Lima, Peru, 5University of Alabama at Birmingham, Birmingham, AL, 6Rheumatology, Hospital Guillermo Almenara Irigoyen, Lima, Peru

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords:

Session Information

Date: Sunday, November 5, 2017

Session Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes

Session Type: ACR Poster Session A

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

Background/Purpose:

Homocysteine level is a predictor of the occurrence of cardiovascular diseases, however, its role as a predictor of damage in SLE has not been studied. The aim of this study is to determine the impact of homocysteine levels on damage accrual in SLE patients.

Methods:

These analyses were conducted in 145 SLE patient, 136 females and 9 males, followed longitudinally at a single center. Evaluations were done every six months and included interview, medical records review, physical examination and laboratory tests. Disease activity was measured with the SLEDAI (Systemic Lupus Erythematosus Disease Activity Index). Damage accrual was ascertained with the SLICC/ACR damage index (SDI). Univariable and multivariable Cox regression models were performed to determine if homocysteine levels were associated with damage accrual. The multivariable model was adjusted for variables known to be associated with this outcome [age at diagnosis, gender, socioeconomic status, disease duration, SLEDAI, antimalarials and immunosuppressive drugs use, average daily dose and time of exposure to prednisone (PDN)].

Results:

The patients mean (SD) age at diagnosis was 43,70 (12,09) years, nearly all were Mestizo. At baseline, disease duration was 7,55 (6,73) years. The SLEDAI was 5,60 (4,34) and the SDI 0,97 (1,35). The average daily dose of PDN was 7,30 (5,78) mg/d and the time of exposure to PDN was 7,36 (6,73) years. Mean homocysteine levels was 10,07 (3.71) µmoles/liter. Patients were followed for 3.54 (1.27) years, and 75 (51.7%) increased at least one point in the SDI. Homocysteine level predicted new damage accrual in the univariable and multivariable models [HR 1.08 (CI95%: 1.03-1.14); p=0.002 and HR: 1.09 (CI95%: 1.02-1.16); p=0.008 respectively.]

Table. Homocysteine level as Predictor of Damage Accrual In SLE (multivariable analyses)

Variables

HR

95% CI

p-value

Homocysteine

1,090

[1,023-1,162]

0,008

Age at diagnosis, years

1,025

[1,001-1,050]

0,045

Disease duration, years

1,058

[0,999-1,121]

0,054

Gender (female)

0,834

[0,292-2,380]

0,734

Socioeconomic status

High

Ref.

Medium status

1,196

[0,602-2,378]

0,609

Low status

1,129

[0,634-2,011]

0,681

SLEDAI, median

1,026

[0,969-1,086]

0,379

Immunosuppressive drugs use

Never

Ref.

Past

0,949

[0,456-1,975]

0,888

Current

1,474

[0,838-2,593]

0,178

Hydroxychloroquine use

Never

Ref.

Past

0,782

[0,294-2,080]

0,622

Current

0,558

[0,266-1,172]

0,124

Prednisone current dose (mg/d)

0,995

[0,955-1,037]

0,821

Time of exposure to prednisone, years

1,000

[0,945-1,059]

0,998

SDI

0,867

[0,688-1,094]

0,229

SDI SLICC/ACR damage index, SLEDAI systemic lupus erythematosus disease activity index

Conclusion:

Homocysteine levels in SLE patients predicted damage accrual independently of other well-known risk factors of damage.

Disclosure: P. Zeña-Huancas, None; M. Ugarte-Gil, None; R. Gamboa-Cárdenas, None; F. Zevallos, None; M. Medina, None; V. Pimentel-Quiroz, None; C. Elera-Fitzcarrald, None; O. Sarmiento-Velasquez, None; C. Reategui-Sokolova, None; M. Cucho-Venegas, None; J. Alfaro-Lozano, None; Z. Rodriguez-Bellido, None; C. A. Pastor-Asurza, None; G. S. Alarcón, None; R. Perich-Campos, None.

To cite this abstract in AMA style:

Zeña-Huancas P, Ugarte-Gil M, Gamboa-Cárdenas R, Zevallos F, Medina M, Pimentel-Quiroz V, Elera-Fitzcarrald C, Sarmiento-Velasquez O, Reategui-Sokolova C, Cucho-Venegas M, Alfaro-Lozano J, Rodriguez-Bellido Z, Pastor-Asurza CA, Alarcón GS, Perich-Campos R. Homocysteine Levels Are Independently Associated with Damage Accrual in Systemic Lupus Erythematosus Patients (SLE) [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/homocysteine-levels-are-independently-associated-with-damage-accrual-in-systemic-lupus-erythematosus-patients-sle/. Accessed January 15, 2021.

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