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  • O35 Timing of thromboembolic events in systemic lupus erythematosus associated to antiphospholipid syndrome; results from a population-based study set in Norway

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O35 Timing of thromboembolic events in systemic lupus erythematosus associated to antiphospholipid syndrome; results from a population-based study set in Norway
  1. Sigrid R Moe1,2,
  2. Hilde Haukeland1,2,3,
  3. Torild Garen1,
  4. Antonela Botea4,
  5. Anniken Orre5,
  6. Heidi Øvreås6,
  7. Thea Bøe7,
  8. Gro Å Wivestad8,
  9. Nenad Damjanic9,
  10. Cathrine Brunborg10,
  11. Sella A Provan11,12,
  12. Øyvind Molberg1,2 and
  13. Karoline Lerang1
  1. 1Dept. of Rheumatology, Oslo University Hospital, Oslo, Norway
  2. 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  3. 3Dept. of Rheumatology, Martina Hansens Hospital, Gjettum, Norway
  4. 4Dept. of Rheumatology, Betanien Hospital, Skien, Norway
  5. 5Dept. of Rheumatology, Vestre Viken Hospital Trust, Drammen, Norway
  6. 6Dept. of Rheumatology, Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway
  7. 7Dept. of Internal Medicine, Vestfold Hospital Trust, Tonsberg, Norway
  8. 8Division of Rheumatology, Dept. of Medicine, Hospital of Southern Norway Trust, Kristiansand, Norway
  9. 9Dept. of Rheumatology, Ostfold Hospital Trust, Graalum, Norway
  10. 10Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
  11. 11Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
  12. 12Section for Public Health, Innland Norway, University of Applied Sciences, Hamar, Norway

Abstract

Objective To estimate occurrence of thromboembolic event in a population-based setting and compare characteristics of new-onset Systemic Lupus Erythematosus (SLE) with and without Antiphospholipid Syndrome (APS).

Methods We included all new-onset SLE cases residing in the Southeast Norway area 1999–2017. Follow-up ended 31 December 2017.All cases had diagnosis confirmed by chart-review, fulfilled the 2019 EULAR/ACR classification criteria and were captured within one year of diagnosis.

All APS fulfilled the 2006 Sapporo classification criteria. Arterial thromboembolic events included ischemic stroke, transient ischemic attack, myocardial infarction or angina pectoris identified either by individual-level chart-review or by ICD-code (G45–46, I63 excluding I63.6, I20-I25, R96) in The National Cause of Death Register. Venous thromboembolic events included syndromes caused by occlusion of major venous vessel identified by chart-review. We estimated incidence rates per 100 person-years at risk and 95% confidence intervals (CI) using Poisson distribution.

Results Of the 749 cases with new-onset SLE 1999–2017, 84 (11%) had coexisting APS. APS cases were more prone to develop thrombocytopenia, neuropsychiatric disease and anti-dsDNA positivity during the disease course than cases without APS (table 1).

By the end of follow-up, 174 (23%) cases had ever experienced at least one arterial or venous event (TE). APS cases were younger at their first TE than those without APS (mean age 37 versus 59, p-value<0.001). TE tended to coincide with SLE diagnosis in APS cases (figure 1).

In the 675 cases without previous TE at SLE diagnosis, 38 and 69 TE occurred within one year and five years disease duration. Overall 5-year incidence rate for TE was 2.6 (95% CI 2.0–3.3). APS cases exhibited a high incidence of TE the first year after SLE diagnosis (51.1, 95% 33.4–74.8), that decreased to 8.6 (95% CI 4.7–14.7) one to five year after SLE diagnosis. Cases without APS had a considerable lower first-year incidence of TE (2.3, 95% CI 1.4–3.8) and the decline were not as pronounce (1–5-year incidence 0.8, 95% CI .0.5–1.2).

Conclusions The risk of APS-related thromboembolic events are high around the time of SLE diagnosis. Awareness of thromboembolic events around the time of SLE diagnosis appear crucial, especially in cases with antiphospholipid antibodies.

Acknowledgements This work was supported by the The Norwegian Women’s Public Health Association, The DAM Foundation, Vivi Irene Hansens Foundation, Ragna and Egil Eiken`s Foundation and the Norwegian Rheumatism Association.

Abstract O35 Figure 1
Abstract O35 Figure 1

Timing of thromboembolic events in new-onset Systemic Lupus Erythematosus with and without Antiphospholipid Syndrome

View this table:
Abstract O35 Table 1

Demographic, cumulative clinical features, medication use and outcome parameters in in new-onset Systemic Lupus Erythematosus with and without Antiphospholipid Syndrome

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.44

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