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460 Flares in patients with systemic lupus erythematosus
  1. K McElhone1,
  2. J Abbott2,
  3. M Hurley3,
  4. P Lanyon4,
  5. A Rahman5,
  6. CS Yee7,
  7. M Akil6,
  8. Y Ahmad8,
  9. I Bruce9,
  10. C Gordon10 and
  11. LS Teh1
  1. 1Royal Blackburn Hospital, Rheumatology, Blackburn, UK
  2. 2University of Central Lancashire, School of Psychology, Preston, UK
  3. 3University of Central Lancashire, College of Health and Wellbeing, Preston, UK
  4. 4Nottingham University Hospitals, Rheumatology, Nottingham, UK
  5. 5University College London, Centre of Rheumatology Research, London, UK
  6. 6Doncaster Royal Infirmary, Rheumatology, Doncaster, UK
  7. 7Royal Hallamshire Hospital, Rheumatology, Sheffield, UK
  8. 8Llandudno Hospital, Peter Maddison Rheumatology Centre, Llandudno, UK
  9. 9University of Manchester, The Kellgren Centre for Rheumatology, Manchester, UK
  10. 10University of Birmingham, Rheumatology Research Group, Birmingham, UK


Background and aims Systemic lupus erythematosus (SLE) is characterised by relapses and remissions. This study describes the frequency, type and time to flare in a cohort of SLE patients.

Methods SLE patients with one or more “A” or “B” BILAG2004 systems meeting flare criteria (items that were “new” or “worse”) and requiring an increase in immunosuppressive therapy were recruited from nine UK centres and assessed at baseline and monthly for nine months. Flares were defined as: severe (“A” flare/s irrespective of number of “B” flares), moderate (2 or more “B” flares without any “A” flares and mild (one “B” flare).

Results Of the 100 patients, 94% were female, 61% white Caucasians, mean age (SD) was 40.7 years (12.7) and mean disease duration (SD) 9.3 years (8.1). A total of 195 flares occurred in 76 patients over 781 monthly assessments, giving a flare rate of 0.25/month. There were 37 severe flares (22 patients), 32 moderate flares (19 patients) and 126 mild flares (67 patients) [Table 1]. The median time to any “A” or “B” flare was 4 months (95% CI 2.7 to 5.3 months). Figure 1 shows the time to the first mild/moderate/severe flare (Curve 1), moderate/severe flare (Curve 2) and severe flare (Curve 3). Table 2 shows that severe and moderate flares tend to be in the system/s affected at baseline whereas mild flares are more likely to affect any system.

Abstract 460 Table 1

Type and frequency of Flares.

Abstract 460 Table 2

BILAG2004 index disease activity system affected at baseline and at time of flare and concordance between the two by severity of flare (npat = number of patients, nflare = number of flare, nsystem = number of times system affected with flares, % = percentage of total number of times systems affected).

Conclusions This real world cohort will share similarities with populations recruited to clinical studies so these results may inform future trial design.

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