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192 Protective effect of antimalarials on the risk of damage accrual in systemic lupus erythematosus
  1. G Pons-Estel1,
  2. D Wojdyla2,
  3. M Ugarte-Gil3,
  4. F Caeiro4,
  5. E Soriano5,
  6. M García6,
  7. C Drenkard7,
  8. G Berbotto8,
  9. E Bonfa9,
  10. G Vazquez10,
  11. L Massardo11,
  12. M Guibert-Toledano12,
  13. V Pascual-Ramos13,
  14. L Barile-Fabris14,
  15. I García De La Torre15,
  16. RM Serrano1,
  17. M.I Segami16,
  18. J Gomez Puerta17,
  19. G Alarcón18 and
  20. B Pons-Estel19
  1. 1Institut Clínic de Medicina i Dermatologia- Barcelona- Spain, of Autoimmune Diseases, Barcelona, Spain
  2. 2Universidad Nacional de Rosario, Estadistica, Rosario, Argentina
  3. 3Hospital Guillermo Almenara Irigoyen. EsSalud, Rheumatology, Lima, Peru
  4. 4Hospital Privado- Córdoba, Servicio de Reumatología, Cordoba, Argentina
  5. 5Hospital Italiano de Buenos Aires, Sección de Reumatología, Buenos Aires, Argentina
  6. 6Hospital Interzonal General de Agudos General San Martín, Reumatología, La Plata, Argentina
  7. 7Emory School of Medicine, Division of Rheumatology, Atlanta, USA
  8. 8Hospital Escuela Eva Perón, Reumatología, Granadero Baigorria, Argentina
  9. 9Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rheumatology, São Pablo, Brazil
  10. 10Universidad de Antioquia- Hospital Universitario- Fundación San Vicente- Medellin, Reumatología, Medellin, Colombia
  11. 11School of Medicine- Pontificia Universidad Católica de Chile, of Clinical Immunology and Rheumatology, Santiago, Chile
  12. 12Centro de Investigaciones Médico Quirúrgicas CIMEQ, Servicio Nacional de Reumatología-, La Habana, Cuba
  13. 13Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Immunology and Rheumatology, México city, Mexico
  14. 14Hospital de Especialidades- Centro Médico Nacional Siglo XXI- Instituto Mexicano del Seguro Social, Clínico de Reumatología, Ciudad de México, Mexico
  15. 15Hospital General de Occidente and Universidad de Guadalajara, Department of Immunology and Rheumatology, Guadalajara, Mexico
  16. 16Universidad Nacional Mayor de San Marcos- Lima- Perú Servicio de Reumatología- Hospital Nacional Edgardo Rebagliati Martins- EsSalud- Lima- Perú, Reumatología, Lima, Peru
  17. 17University of Antioquia- Medellín, Rheumatology, Medellin, Colombia
  18. 18The University of Alabama at Birmingham, of Medicine- Division of Clinical Immunology and Rheumatology, Birmingham, USA
  19. 19Hospital Provincial de Rosario, Rheumatology, Rosario, Argentina

Abstract

Background and aims Antimalarials (AMs) have been shown to exert a reduced risk of damage accrual in North American and European SLE patients. We are presenting data from Latin American patients.

Methods Patients with a recent SLE diagnosis (≤2 years) from the GLADEL cohort were studied. End-point: Increase in damage (SLICC Damage Index, SDI) since cohort entry.

Independent (socio-demographic, clinical laboratory and treatment) variables were included. The effect of AMs use on damage (adjusting for potential confounders) was examined with a multivariable Cox regression model with a stepwise selection algorithm (variables retained in the model α: 0.05). AMs was a time-dependent variable (user: patient receiving AMs during the previous 30 days) in the regression model.

Results Of the 1466 patients included in this analysis 1049 (72%) received AMs during follow-up (as defined); median exposure time: 30 months (Q1-Q3: 11–57 months). Damage accrual occurred in 665 (45%) patients during a median follow up time of 24 months (Q1-Q3: 8–55) months. After adjusting for potential confounders (SDI at cohort entry, socioeconomic status, disease duration at cohort entry, malar rash, photosensitivity, serositis, oral glucocorticoids, pulse glucocorticoids and SLEDAI at cohort entry) at any time during follow-up, a patient on AMs had a 25% lower risk of damage accrual than a patient not on AMs (adjusted HR 0.75, 95% CI 0.62–0.90).

Conclusions After adjustment for possible confounding factors related to AMs use and damage accrual, AMs were independently associated with a reduced risk of damage accrual in this cohort.

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