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464 Lupus low disease activity state: prevalence and effect on damage accrual in a monocentric cohort of 293 sle patients
  1. A Doria,
  2. M Zen,
  3. F Saccon,
  4. M Gatto,
  5. M Larosa and
  6. L Iaccarino
  1. University of Padova, Department of Medicine DIMED- Division of Rheumatology, Padova, Italy

Abstract

Background and aims To assess the prevalence and validate the effect on damage accrual of the recently defined “Lupus Low Disease Activity State”(LLDAS) in a monocentric cohort of patients with Systemic Lupus Erythematosus (SLE).

Methods We studied 293 Caucasian SLE patients during 7 year follow-up. Disease activity was assessed by SLEDAI-2K and SELENA-SLEDAI physician global assessment (PGA), and damage by SLICC/ACR Damage Index (SDI). Franklyn et al1 definition of LLDAS was applied: (1) SLEDAI-2K≤4, with no activity in major organ systems (renal, central nervous system, cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus activity compared with the previous assessment; (3) a PGA (scale 0–3)≤1; (4) current prednisolone-equivalent dose ≤7.5 mg/day; (5) stable maintenance dose of immunosuppressants.

The effect of different durations of LLDAS (1, 2, 3, 4,≥5 consecutive years) on SDI was evaluated by multivariate logistic regression analysis.

Results The prevalence of LLDAS and damage in the cohort are reported in Table 1.

Abstract 464 Table 1
Abstract 464 Table 1

Demographics and prevelance of LLDAS and damage in the study cohort.

Patients who spent at least 2 consecutive years in LLDAS had significantly reduced damage accrual compared with patients never in LLDAS (p=0.001). Interestingly, among the 254 patients achieving LLDAS for at least 1 year, 231 (90.9%) had clinical-SLEDAI-2K=0. At multivariate analysis, a LLDAS lasting at least two years was protective against damage (Table 2). Conversely, major independent predictors of damage were cumulative prednisone dose ≥180 mg/month and antiphospholipid antibody syndrome (Table 2).

Abstract 464 Table 2
Abstract 464 Table 2

Multivariate analysis: independent risk factors and protective factors for damage accrual over the follow-up.

Conclusions Two consecutive years was the shortest LLDAS duration associated with a decrease in damage progression in Caucasian SLE patients.

Reference

  1. Franklyn K, et al. Ann Rheum Dis 2016;75:1615–1621.

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