ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1587

Mycobacterial Infection in Systemic Lupus Erythematosus: Clinical Significance and Associated Factors. Data from the Registry of Patients with SLE of the Spanish Society of Rheumatology (RELESSER)

Ana Lois-Iglesias1, Víctor del Campo-Pérez2, Iñigo Rúa-Figueroa3, Coral Mouriño-Rodriguez4, Francisco Javier López Longo5, María Galindo6, Jaime Calvo-Alen7, Jesús Ibañez Ruán8, Alejandro Olivé9, Rafael-Benito Melero González4, Antonio Fernandez-Nebro10, José Antonio Bernal11, Celia Erausquin12, Eva Tomero13, Maria Loreto Horcada14, Esther Uriarte15, Mercedes Freire16, Carlos Alberto Montilla-Morales17, Ana Sánchez Atrio18, Alina Boteanu19, Elvira Diez Alvarez20, Javier Narváez21, Víctor Martínez Taboada22, Lucía Silva Fernández23, Esther Ruiz Lucea24, Jose Luis Andreu25, José Hernández Beiraín26, Marian Gantes27, Blanca Hernández-Cruz28, Jose Javier Perez Venegas29, Ángela Pecondón Español30, Nuria Lozano-Rivas31, Monica Ibanez Barcelo32, Gema Bonilla33, Vicente Torrente34, Ivan Castellví35, Juan José Alegre36, Mireia Moreno37, José Luis Marenco de la Fuente38, Cesar Magro-Checa39, Tomás Vázquez Rodríguez40, Victor Quevedo41, Patricia Richi42, Maria Teresa Oton Sanchez43 and JM Pego-Reigosa44, 1Rheumatology, University Hospital A Coruña, A Coruña, Spain, 2Preventive Medicine and Epidemiology, EOXI Vigo, Vigo, Spain, 3Rheumatology Division, Hospital Doctor Negrin, Las Palmas GC, Spain, 4Rheumatology, EOXI Vigo, Vigo, Spain, 5Rheumatology, Hospital Gregorio Marañón, Madrid, Spain, 6Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, 7Rheumatology, Txagorritxu Hospital, Araba, Vitoria, Vitoria, Spain, 8POVISA, Rheumatology, Vigo, Spain, 9Rheumatology, Hospital Germans Trias i Pujol, Badalona, Spain, 10Rheumatology, Regional Universitary Hospital of Málaga, Malaga, Spain, 11Reumatología, Hospital Universitario del Vinalopó, Elche, Spain, 12Rheumatology, Hospital de Gran Canaria Dr Negrin, Las Palmas GC, Spain, 13Hospital La Princesa. Madrid., Madrid, Spain, 14Rheumatology, Complejo Hospitalario de Navarra, Pamplona, Spain, 15Reumatología, Hospital de Donosti, Donosti, Spain, 16Servicio de Reumatología. Instituto de Investigación Biomédica de A Coruña (INIBIC). Complexo HospitalarioUniversitario de A Coruña (CHUAC), Sergas. Universidade da Coruña (UDC), A Coruña, Spain, 17Hospital Clínico Universitario de Salamanca, Salamanca, Spain, 18University Hospital Príncipe de Asturias, Immune System Diseases, Rheumatology Department, Alcalá de Henares, Madrid, Spain, 19University Hospital Ramón y Cajal, Madrid, Spain, 20Complejo Asistencial Universitario de León. León. Spain, León, Spain, 21Rheumatology Department, Hospital de Bellvitge. Barcelona. Spain, L’Hospitalet de Llobregat, Spain, 22Rheumatology, Hospital Marqués de Valdecilla, Santander, Spain, 23Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom, 24Hospital de Basurto, Bilbao, Spain, 25Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, 26Rheumatology, Hospital Insular de Gran Canaria, Las palmas Gran Canarias, Spain, 27Rheumatology, Hospital Universitario de Canarias, La Laguna; Tenerife, Spain, 28Rheumatology, Hospital Universitario Virgen Macarena, Sevilla, Spain, 29Rheumatology, Hospital de Jerez de la Frontera, Jerez de la Frontera, Spain, 30Rheumatology, Hospital Miguel Servet, Zaragoza, Spain, 31Rheumatology, Hospital Virgen de la Arrixaca, murcia, Spain, 32H. Son Llatzer, Palma de Mallorca, Spain, 33Hospital Universitario La Paz, Madrid, Spain, 34Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain, 35Rheumatology, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain, 36Sección de Reumatología Hospital Universitario Dr Peset Valencia, Valencia, Spain, 37Rheumatology, Hospital Universitari Parc Taulí, Sabadell, Spain, 38Rheumatology, Hospital de Valme, Seville, Spain, 39Department of Rheumatology, Leiden University Medical Center, Leiden, Spain, 40Rheumatology, Hospital Lucus Augusti, Lugo, Spain, 41Rheumatology, Hospital de Monforte, Lugo, Spain, 42Hospital Infanta Sofía, Madrid, Spain, 43Rheumatology Department. Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain, 44Rheumatology Section, Hospital de Meixoeiro, Pontevedra, Spain, Vigo, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Monday, November 6, 2017

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster II: Damage and Comorbidities

Session Type: ACR Poster Session B

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

Background/Purpose:

The aim of this work is to study the prevalence of mycobacterial infection (M.I.), the associated factors and their clinical significance in patients included in a large SLE cohort.

Methods:

Retrospective descriptive study of RELESSER patients with a history of M.I. and analysis of the factors associated with the infection of this etiology.

Results:

In RELESSER 3,658 SLE patients were included. 90% are women with a mean age of 32.9 years. 93% are Caucasians. The mean follow-up time (± S.D.) was 120.2 (± 87.6) months. 705 (19.3%) patients had at least a serious infection, 1,227 serious infections occurred. M.I. were diagnosed in 42 patients (1.2% of all RELESSER patients, 3.4% of all serious infections), 85.7% women. The incidence rate of mycobacterial infection was 1 per 1,000 patients/year (95%CI:0.7-1.4).

M.I. presentation was pulmonary in 18 (42.9%) patients and extrapulmonary in 24 (57.1%) patients [joints in 8 (19.0%) patients, soft tissue in 6 (14.3%) and other sites in 10 (23.8%)]. The extrapulmonary form was associated with the use of immunosuppressants: 84.6% of the 13 patients treated with immunosuppressive drugs versus 44.4% of the 27 patients without (p=0.01). We did not observe this association with the use of corticosteroids.

To study the factors associated with mycobacterial infection, we performed a bivariate analysis including the variables associated with severe infection identified in RELESSER (age, sex, ethnicity, use of corticosteroids, immunosuppressants, antimalarials, previous admission by SLE activity, use of rituximab, use of anti-TNF, Katz severity index, SDI damage index, SLEDAI activity index and Charlson comorbidity index). There is a statistically significant association with previous admission by SLE activity (RR:2.9, 95-95%:1.3-6.2, p=0.007), renal impairment (RR:2.0, CI 95%:1,1-3,7, p=0,04), the Katz score (RR:2.1, 95% CI:1.1- 4.0, p=0.04) and the Charlson index (RR: 2.5; 95% CI: 1.3-4.8, p=0.009). The accumulated damage (SDI> 0) was closely associated with significance:RR: 2.0; 95% CI: 1.0-4.0, p=0.07. The use of immunosuppressants was associated with a significant increase in the risk of mycobacterial infection: RR:4.3; 95% CI:2.2-8.3, p=0.31.

Two patients (4.8%) died (1 respiratory and 1 extrapulmonary). The mean survival after diagnosis in these cases was 21 days.

Conclusion:

M.I. in RELESSER affects 1.15% of patients. Its incidence rate is 1 per 1,000 patients/year (95%CI:0.7-1.4). Extrapulmonary localization affects more than half of the patients and is associated with the use of immunosuppressants. Previous admission by SLE activity, renal involvement, severity of SLE, and increased number of associated comorbidities are factors associated with the existence of mycobacterial infection.

Disclosure: A. Lois-Iglesias, None; V. del Campo-Pérez, None; I. Rúa-Figueroa, None; C. Mouriño-Rodriguez, None; F. J. López Longo, None; M. Galindo, None; J. Calvo-Alen, None; J. Ibañez Ruán, None; A. Olivé, None; R. B. Melero González, None; A. Fernandez-Nebro, None; J. A. Bernal, None; C. Erausquin, None; E. Tomero, None; M. L. Horcada, None; E. Uriarte, None; M. Freire, None; C. A. Montilla-Morales, None; A. Sánchez Atrio, None; A. Boteanu, None; E. Diez Alvarez, None; J. Narváez, None; V. Martínez Taboada, None; L. Silva Fernández, None; E. Ruiz Lucea, None; J. L. Andreu, None; J. Hernández Beiraín, None; M. Gantes, None; B. Hernández-Cruz, None; J. J. Perez Venegas, None; Á. Pecondón Español, None; N. Lozano-Rivas, None; M. Ibanez Barcelo, None; G. Bonilla, None; V. Torrente, None; I. Castellví, None; J. J. Alegre, None; M. Moreno, None; J. L. Marenco de la Fuente, None; C. Magro-Checa, None; T. Vázquez Rodríguez, None; V. Quevedo, None; P. Richi, None; M. T. Oton Sanchez, None; J. Pego-Reigosa, None.

To cite this abstract in AMA style:

Lois-Iglesias A, del Campo-Pérez V, Rúa-Figueroa I, Mouriño-Rodriguez C, López Longo FJ, Galindo M, Calvo-Alen J, Ibañez Ruán J, Olivé A, Melero González RB, Fernandez-Nebro A, Bernal JA, Erausquin C, Tomero E, Horcada ML, Uriarte E, Freire M, Montilla-Morales CA, Sánchez Atrio A, Boteanu A, Diez Alvarez E, Narváez J, Martínez Taboada V, Silva Fernández L, Ruiz Lucea E, Andreu JL, Hernández Beiraín J, Gantes M, Hernández-Cruz B, Perez Venegas JJ, Pecondón Español Á, Lozano-Rivas N, Ibanez Barcelo M, Bonilla G, Torrente V, Castellví I, Alegre JJ, Moreno M, Marenco de la Fuente JL, Magro-Checa C, Vázquez Rodríguez T, Quevedo V, Richi P, Oton Sanchez MT, Pego-Reigosa J. Mycobacterial Infection in Systemic Lupus Erythematosus: Clinical Significance and Associated Factors. Data from the Registry of Patients with SLE of the Spanish Society of Rheumatology (RELESSER) [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/mycobacterial-infection-in-systemic-lupus-erythematosus-clinical-significance-and-associated-factors-data-from-the-registry-of-patients-with-sle-of-the-spanish-society-of-rheumatology-relesser/. Accessed .

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