Purpose To examine the prevalence of comorbidities in SLE patients at the community as well as their impact on disease outcomes.¹

Methods We utilised data from the Cretan Lupus Registry.² Comorbidities were defined based on self-reported condition(s) and/or use of relevant treatments, and were accessed through face interviews upon enrollment (period 2012–2015). Data on organ damage (SLICC/ACR Damage Index [SDI]), disease severity (modified BILAG index) and hospitalizations were abstracted from the medical charts.

Results We included 399 SLE patients with mean age at diagnosis 43 years and disease duration 7 years. The total number of comorbidities was (mean ±SD) 3.4±2.4 and 42% of patients had multi-morbidity (>3 comorbidities). The mean Charlson Comorbidity Index was 0.9±1.1. The prevalence of major comorbidities in SLE patients and their co-occurrence matrix are shown in Figure 1 and Table 1, respectively. Most frequent physical comorbidity was thyroid disease (45%), which frequently (19%) concurred with a mental disorder. Although 36% of patients reported mental disorders, only 14% were regularly seen by a mental health professional. Female SLE patients had increased frequency of thyroid (51% versus 16%, p<0.001), allergic diseases (21% versus 3%, p=0.006), and osteoporosis (19% versus 6%, p=0.05) compared to male patients, whereas respiratory comorbidities (21% versus 9%, p<0.001) and alcohol abuse (3% versus 0%, p<0.01) were more prevalent among male patients. Analysis according to the place of residence revealed increased prevalence of respiratory comorbidities among patients who reside in rural (12.3%) versus urban (7.2%) or semi-urban (7.7%) regions (p=0.014). SLE patients with multi-morbidity had more hospitalizations due to active disease (2.2±5.8 versus 1.1±2.3, p<0.001) and increased organ damage accrual (SDI>0) (40.8% versus 28.5%, p=0.044) compared to those with ≤3 comorbidities. In multivariable analysis, age-adjusted Charlson Comorbidity Index was associated with disease severity (Odds Ratio 1.43, p<0.003)

Conclusions Our results from a community-based registry highlight a considerable burden of physical and mental multi-morbidity in SLE patients, which may be linked to adverse disease outcomes.

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Abstract PS3:51 Figure 1

Prevalence of physical (1A) and mental comorbidities (1B) of SLE patients (n=399) at the community level (cretan lupus registry)

References

1. . Expert Rev Clin Immunol2017;13(8):753–768.

2. . Gergianaki I, et al. Ann Rheum Dis2017.