Predictive Factors According to Type of Infection in Systemic Lupus Erythematosus Patients: Data from a Multi-Ethnic, Multi-National, Latin-American Cohort

Victor R. Pimentel-Quiroz¹, Manuel Ugarte-Gil¹, Guillermo J. Pons-Estel², Daniel Wojdyla³, Mario Cardiel⁴, Virginia Pascual-Ramos⁵, Ignacio Garcia-De La Torre⁶, Leonor Barile⁷, Mary Carmen Amigo⁸, Luis H. Silveira⁹, Maria Josefina Sauza del Pozo¹⁰, Marlene Guibert-Toledano¹¹, Gil A. Reyes¹², Antonio Iglesias-Gamarra¹³, Gloria Vasquez¹⁴, José Fernando Molina¹⁵, Jose A Gómez-Puerta¹⁶, Luis Alonso Gonzalez¹⁷, Rosa Chacón-Díaz¹⁸, Maria H Esteva Spinetti¹⁹, Isaac Abadi¹⁹, Eduardo M. Acevedo-Vásquez²⁰, Jose Alfaro-Lozano²¹, Ines Segami²², Loreto Massardo²³, Oscar Neira²³, Emilia Sato²⁴, Eloisa Bonfa²⁵, Eduardo Borba²⁶, Graciela S. Alarcón²⁷ and Bernardo Pons-Estel²⁸, ¹Peru, GLADEL, Lima, Peru, ²GLADEL, Rosario, Argentina, ³GLADEL consultant, Rosario, Argentina, ⁴Centro de Investigación Clínica de Morelia SC, Morelia, Mexico, ⁵Instituto Nacional de Ciencias Médicas y Nutrició, Mexico City, Mexico, ⁶Immunology & Rheumatology, Centro de Est. de Invest. Bas. y Clin., S.C., Guadalajara, JAL, Mexico, ⁷GLADEL, Mexico, Mexico, ⁸Centro Medico ABC, Mexico, Mexico, ⁹Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City DF, Mexico, ¹⁰Servicio de Reumatología, Instituto Mexicano de Seguro Social, Hospital de Especialidades Nº 25, Monterrey, Mexico, ¹¹Centro de Investigaciones Médico Quirúrgicas, Habana, Centro de Investigaciones Médico Quirúrgicas, Habana, La Habana, Cuba, ¹²GLADEL, Havana, Cuba, ¹³Clinical Development, Nordic Bioscience, Herlev, Denmark, ¹⁴GLADEL, Colombia, Antioquia, Colombia, ¹⁵GLADEL, Colombia, Antoquia, Colombia, ¹⁶Grupo de Reumatología, Universidad de Antioquia, Medellín, Colombia, ¹⁷Medicarte IPS, Medellín, Colombia, ¹⁸Servicio de Reumatología, Hospital Universitario de Caracas, Centro Nacional de Enfermedades Reumáticas, Caracas, Venezuela, ¹⁹GLADEL, Caracas, Venezuela (Bolivarian Republic of), ²⁰Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru, ²¹Rheumatology, Hospital Guillermo Almenara Irigoyen. EsSalud, Lima, Peru, ²²GLADEL, Peru, Lima, Peru, ²³GLADEL, Santiago, Chile, ²⁴Rheumatology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil, ²⁵Rheumatology Divison, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, ²⁶Faculdade de Medicina, Hospital das Clínicas. Universidade de São Paulo, São Paulo, Brazil, ²⁷University of Alabama at Birmingham, Birmingham, AL, ²⁸GLADEL, Rosario, Santa Fe, Argentina

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Systemic lupus erythematosus (SLE)

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: While infections are a one of the main causes of mortality in systemic lupus erythematosus (SLE), the type of infections and the factors predisposing to them have not been properly evaluated. The aim of the present study was to identify predictive factors accounting for the different types of infections in SLE patients.

Methods: A multi-ethnic, multi-national cohort from nine countries was utilized for these analyses. The following type of infections were considered: skin, lung, urinary tract, digestive tract and gynecological. Cox regression models were used to evaluate the predictors of new infections (global and per organs involved) using a backward elimination procedure. Potential predictors were demographic factors, clinical manifestations, SLEDAI, SDI and treatment at baseline.

Results: Predictive factors of skin infections were dose of prednisone between 15 and 60mg/d (HR: 1.73; CI: 1.16-2.57) and ≥60mg/d (HR: 1.63; CI: 1.01-1.91), lymphopenia (HR: 1.38; CI: 1.01-1.91), shorter disease duration at baseline (HR: 0.94; CI: 0.91-0.97), and previous infections (HR: 1.77; CI: 1.18-2.65). Predictive factors of lower airway infections were previous infections (HR: 2.39; CI: 1.38-4.13), lung involvement (HR: 2.81; CI: 1.38-5.71), and shorter disease duration at baseline (HR: 0.94; CI: 0.90-0.98). Predictive factors of urinary tract infections were higher damage at baseline (HR: 1.17; CI: 1.02-1.35), older age at diagnosis (HR: 1.02; CI: 1.01-1.03), shorter disease duration at baseline (HR: 0.93; CI: 0.89-0.96), female gender (HR: 3.03; CI: 1.11-8.23), and Mestizo ethnicity (HR: 1.98; CI: 1.29-3.04). Predictive factors of digestive tract infections were higher disease activity at baseline (HR: 1.05; CI: 1.02-1.08), lower socioeconomic status (HR: 2.1; CI: 1.02-4.40), and lower educational level (HR: 0.36; CI: 0.16-0.78). Predictive factors of gynecological infections were dose of prednisone between 15 and 60mg/d (HR: 2.05; CI: 1.05-3.99) and higher disease activity at baseline (HR: 1.03; CI: 1.01-1.07).

Conclusion: Female gender, older age at diagnosis, lower socioeconomic status, lower educational level, shorter disease duration, lymphopenia, previous infections, lung involvement, higher damage accrual, higher disease activity, dose of prednisone >15mg/d, and Mestizo ethnicity were predictive of at least one type of infection.

Disclosure: V. R. Pimentel-Quiroz, None; M. Ugarte-Gil, None; G. J. Pons-Estel, None; D. Wojdyla, None; M. Cardiel, None; V. Pascual-Ramos, None; I. Garcia-De La Torre, None; L. Barile, None; M. C. Amigo, None; L. H. Silveira, None; M. J. Sauza del Pozo, None; M. Guibert-Toledano, None; G. A. Reyes, None; A. Iglesias-Gamarra, None; G. Vasquez, None; J. Fernando Molina, None; J. A. Gómez-Puerta, AbbVie,BMS, Pfizer, Roche, 8; L. A. Gonzalez, None; R. Chacón-Díaz, None; M. H. Esteva Spinetti, None; I. Abadi, None; E. M. Acevedo-Vásquez, None; J. Alfaro-Lozano, None; I. Segami, None; L. Massardo, None; O. Neira, None; E. Sato, None; E. Bonfa, None, 2; E. Borba, None; G. S. Alarcón, None; B. Pons-Estel, None.

To cite this abstract in AMA style:

Pimentel-Quiroz VR, Ugarte-Gil M, Pons-Estel GJ, Wojdyla D, Cardiel M, Pascual-Ramos V, Garcia-De La Torre I, Barile L, Amigo MC, Silveira LH, Sauza del Pozo MJ, Guibert-Toledano M, Reyes GA, Iglesias-Gamarra A, Vasquez G, Fernando Molina J, Gómez-Puerta JA, Gonzalez LA, Chacón-Díaz R, Esteva Spinetti MH, Abadi I, Acevedo-Vásquez EM, Alfaro-Lozano J, Segami I, Massardo L, Neira O, Sato E, Bonfa E, Borba E, Alarcón GS, Pons-Estel B. Predictive Factors According to Type of Infection in Systemic Lupus Erythematosus Patients: Data from a Multi-Ethnic, Multi-National, Latin-American Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/predictive-factors-according-to-type-of-infection-in-systemic-lupus-erythematosus-patients-data-from-a-multi-ethnic-multi-national-latin-american-cohort/. Accessed .

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