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Abstract Number: 2648

Relationship between Damage and Mortality in Juvenile-Onset Systemic Lupus Erythematosus: Cluster Analyses in a Large Cohort from the Spanish Society of Rheumatology Lupus Registry

JM Pego-Reigosa1, TC Salman-Monte2, Irene Altabás-González3, Iñigo Rúa-Figueroa4, Jacobo de Uña5, V Balboa-Barreiro6, Francisco Javier López Longo7, María Galindo8, Jaime Calvo-Alen9, Alejandro Olivé-Marqués10, Coral Mouriño-Rodriguez11, Eva Tomero12, Maria Loreto Horcada13, Ana Sánchez Atrio14, Carlos Alberto Montilla-Morales15, Eva Salgado16, Elvira Diez Alvarez17, Ricardo Blanco18, Jose Luis Andreu19, O Fernández-Berrizbeitia20, José Hernández Beiraín21, Marian Gantes22, Blanca Hernández-Cruz23, Angela Pecondon-Español24, Carlos Marras Fernandez-Cid25, María Gema Bonilla Hernán26, Jesús García-Villanueva27 and Vicente Torrente28, 1Complexo Hospitalario Universitario de Vigo, Vigo, Spain, 2Rheumatology, Hospital del Mar/Parc de Salut Mar, Barcelona, Spain, 3Rheumatology, Hospital Doctor Negrin, Las Palmas GC, Spain, 4Rheumatology Division, Hospital Doctor Negrin, Las Palmas GC, Spain, 5Statistics and OR, Vigo University, Vigo, Spain, 6Department of Statistics and OR, Vigo University, Vigo (Spain), Vigo, Spain, 7Rheumatology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 8Servicio de Reumatología, Hospital 12 de Octubre, Madrid, Spain, 9Rheumatology, Txagorritxu Hospital, Araba, Vitoria, Vitoria, Spain, 10Rheumatology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain, 11Rheumatology, Rheumatology Section, Complexo Hospitalario Universitario de Vigo, Pontevedra, Spain, Vigo, Spain, 12Rheumatology, Hospital de La Princesa. Madrid. Spain, Madrid, Spain, 13Rheumatology, Hospital de Navarra, Pamplona, Spain, 14University Hospital Príncipe de Asturias, Immune System Diseases, Rheumatology Department, Alcalá de Henares, Madrid, Spain, 15Hospital Clínico Universitario de Salamanca. Spain, Salamanca, Spain, 16RheumatologyDepartment, Hospital Complex of Ourense, Ourense (Spain), Ourense, Spain, 17Complejo Asistencial Universitario de León, León, Spain, 18Rheumatology Department,, Hospital Marqués de Valdecilla, Santander, Spain, 19Rheumatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain, 20Rheumatology Department Basurto Hospital, País Vasco, Basurto (Spain), Bilbao, Spain, 21Rheumatology, Hospital Insular de Gran Canaria, Las palmas Gran Canarias, Spain, 22Rheumatology, Hospital Universitario de Canarias, La Laguna; Tenerife, Spain, 23Rheumatology, Hospital Universitario Virgen Macarena, Sevilla, Spain, 24Rheumatology, Hospital Miguel Servet, Zaragoza, Spain, 25Rheumatology, Hospital Virgen de la Arrixaca, Murcia, Spain, 26Rheumatology Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain, 27HOSPITAL RAMÓN Y CAJAL, Madrid, Spain, 28Hospital de dia Baix de LLobregat, LLobregat, Spain

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Juvenile SLE and morbidity and mortality

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Session Information

Date: Tuesday, October 23, 2018

Session Title: Systemic Lupus Erythematosus – Clinical Poster III: Treatment

Session Type: ACR Poster Session C

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

Background/Purpose: To identify patterns (clusters) of damage manifestation within a large cohort of juvenile SLE (jSLE) patients and evaluate their possible association with mortality.

Methods: This is a multicentre, descriptive, cross-sectional study of a cohort of 345 jSLE patients from the Spanish Society of Rheumatology Lupus Registry (RELESSER). Organ damage was ascertained using the Systemic Lupus International Collaborating Clinics Damage Index. Using cluster analysis, groups of patients with similar patterns of damage manifestation were identified and compared.

Results: Mean age (years) ± S.D. at diagnosis was 14.2 ± 2.89; 88.7% were female and 93.4% were Caucasian. Mean SLICC/ACR DI ± S.D. was 1.27 ± 1.63. A total of 12 (3.5%) patients died. Three damage clusters were identified: Cluster 1 (72.7% of patients) presented a lower number of individuals with damage (22.3% vs. 100% in Clusters 2 and 3, P<0.001); Cluster 2 (14.5% of patients) was characterized by renal damage in 60% of patients, significantly more than Clusters 1 and 3 (P<0.001), in addition to increased more ocular, cardiovascular and gonadal damage; Cluster 3 (12.7%) was practically the only group with musculoskeletal damage (100%), significantly higher than in Clusters 1 and 2 (P<0.001). The overall mortality rate in Cluster 2 was 2.2 times higher than that in Cluster 3 and 5 times higher than that in Cluster 1 (p<0.017 for both comparisons).

Conclusion: In a large cohort of jSLE patients, renal and musculoskeletal damage manifestations were the two dominant forms of damage by which patients were sorted into clinically meaningful clusters. We found two clusters of jSLE with important clinical damage that were associated with higher rates of mortality, especially for the cluster of patients with predominant renal damage. Physicians should be particularly vigilant to the early prevention of damage in this subset of jSLE patients with kidney involvement.


Disclosure: J. Pego-Reigosa, None; T. Salman-Monte, None; I. Altabás-González, None; I. Rúa-Figueroa, None; J. de Uña, None; V. Balboa-Barreiro, None; F. J. López Longo, None; M. Galindo, None; J. Calvo-Alen, None; A. Olivé-Marqués, None; C. Mouriño-Rodriguez, None; E. Tomero, None; M. L. Horcada, None; A. Sánchez Atrio, None; C. A. Montilla-Morales, None; E. Salgado, None; E. Diez Alvarez, None; R. Blanco, None; J. L. Andreu, None; O. Fernández-Berrizbeitia, None; J. Hernández Beiraín, None; M. Gantes, None; B. Hernández-Cruz, None; A. Pecondon-Español, None; C. Marras Fernandez-Cid, None; M. G. Bonilla Hernán, None; J. García-Villanueva, None; V. Torrente, None.

To cite this abstract in AMA style:

Pego-Reigosa J, Salman-Monte T, Altabás-González I, Rúa-Figueroa I, de Uña J, Balboa-Barreiro V, López Longo FJ, Galindo M, Calvo-Alen J, Olivé-Marqués A, Mouriño-Rodriguez C, Tomero E, Horcada ML, Sánchez Atrio A, Montilla-Morales CA, Salgado E, Diez Alvarez E, Blanco R, Andreu JL, Fernández-Berrizbeitia O, Hernández Beiraín J, Gantes M, Hernández-Cruz B, Pecondon-Español A, Marras Fernandez-Cid C, Bonilla Hernán MG, García-Villanueva J, Torrente V. Relationship between Damage and Mortality in Juvenile-Onset Systemic Lupus Erythematosus: Cluster Analyses in a Large Cohort from the Spanish Society of Rheumatology Lupus Registry [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/relationship-between-damage-and-mortality-in-juvenile-onset-systemic-lupus-erythematosus-cluster-analyses-in-a-large-cohort-from-the-spanish-society-of-rheumatology-lupus-registry/. Accessed December 10, 2019.
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