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Clinical Sciences
CS-08 Effect of antimalarials over the different domains of the damage index in latin american SLE patients
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  1. Bernardo Pons-Estel1,
  2. Daniel Wojdyla2,
  3. Graciela S Alarcón3,
  4. Rosa María Serrano1,
  5. Rosana Quintana1,
  6. Manuel Ugarte-Gil4,
  7. Víctor Pimentel-Quiroz4,
  8. Enrique R Soriano5,
  9. Marina Scolnik5,
  10. Mónica Sacnun1,
  11. José A Gómez-Puerta6,
  12. Mario H Cardiel7,
  13. Virginia Pascual-Ramos8,
  14. Ignacio García de la Torre9,
  15. Leonor A Barile10,
  16. Luis H Silveira11,
  17. Mary Carmen Amigo12,
  18. María Josefina Sauza del Pozo13,
  19. Marlene Guibert-Toledano14,
  20. Gil A Reyes14,
  21. Antonio Iglesias Gamarra15,
  22. Luis Alonso Gonzalez6,
  23. Rosa Chacón-Díaz16,
  24. María H Esteva Spinetti17,
  25. Eduardo M Acevedo-Vásquez4,
  26. José Alfaro-Lozano4,
  27. María Inés Segami18,
  28. Loreto Massardo19,
  29. Oscar Neira20,
  30. Emilia Sato21,
  31. Eloisa Bonfa22,
  32. Lilian Costallat23,
  33. Ricardo Xavier24,
  34. Fernando Cavalcanti25,
  35. Nilizio A Da Silva26,
  36. Eduardo Ferreira Borba22,
  37. Luis J Catoggio5,
  38. Joao C Tavares Brenol24,
  39. Verónica Saurit27,
  40. Francisco Caeiro27,
  41. Alejandro Alvarellos27,
  42. Judith Sarano28,
  43. Mercedes Garcia29,
  44. Laura Onetti30,
  45. Cristina Drenkard31,
  46. Guillermo Berbotto32,
  47. Hugo R Scherbarth33,
  48. Sergio Jacobelli34,
  49. José F Molina35,
  50. Gloria Vásquez6 and
  51. Guillermo J Pons-Estel1
  1. 1Hospital Provincial de Rosario, Argentina
  2. 2GLADEL Consultant, Argentina
  3. 3University of Alabama at Birmingham, USA
  4. 4Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Perú
  5. 5Hospital Italiano de Buenos Aires, Argentina
  6. 6Universidad de Antioquia, Colombia
  7. 7Centro de Investigación Clínica de Morelia SC, México
  8. 8Instituto Nacional de Ciencias Médicas y Nutrición, México
  9. 9Hospital General de Occidente, México
  10. 10Hospital Ángeles del Pedregal, México
  11. 11Instituto Nacional de Cardiología Ignacio Chávez, México
  12. 12Centro Medico ABC, México
  13. 13Instituto Mexicano de Seguro Social, Hospital de Especialidades N° 25, México
  14. 14Centro de Investigaciones Médico Quirúrgicas, Cuba
  15. 15Universidad Nacional de Bogotá, Colombia
  16. 16Hospital Universitario de Caracas, Centro Nacional de Enfermedades Reumáticas, Venezuela
  17. 17Hospital Central de San Cristóbal, Venezuela
  18. 18Hospital Nacional Edgardo Rebagliatti Martins, ESSALUD, Perú
  19. 19Universidad San Sebastián, Chile
  20. 20Hospital del Salvador, Chile
  21. 21Universidade Federal de Sao Paulo, Brasil
  22. 22Faculdade de Medicina da Universidade de São Paulo, Brasil
  23. 23Universidade Estadual da Campinas, Campinas, Brasil
  24. 24Hospital da Clinicas da Porto Alegre, Brasil
  25. 25Universidade Federal da Pernambuco, Brasil
  26. 26Faculdade de Medicina, Universidade Federal de Goias, Brasil
  27. 27Hospital Privado Universitario de Córdoba, Argentina
  28. 28Instituto de Investigaciones Medicas Alfredo Lanari, Argentina
  29. 29HIGA General San Martin La Plata, Argentina
  30. 30Hospital Nacional de Clínicas, Argentina
  31. 31Emory University School of Medicine, USA
  32. 32Sanatorio Británico, Argentina
  33. 33Hospital Interzonal General de Agudos ‘‘Dr. Oscar Alende’’
  34. 34Argentina; Pontificia Universidad Católica de Chile, Chile
  35. 35Centro Integral de Reumatología, Reumalab, Colombia

Abstract

Background We have previously shown that Latin American SLE patients treated with Antimalarials (AMs) have a 25% lower risk of damage accrual than patients not receiving them. The present study was conducted to assess the effects of AMs over the 12 items of the SLICC Damage Index, (SDI).

Methods Patients with a recent SLE diagnosis (≤2 years) from the GLADEL cohort were studied. End-point: Increase in the 12 items SDI since cohort entry. Independent (socio-demographic, clinical laboratory and treatment) variables were included. The effect of AMs as a time dependent variable on items of the SDI (adjusting for potential confounders) was examined with a multivariable Cox regression model. Multivariate models were developed for the most common SDI items.

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). Total damage accrual occurred in 665 (45%) patients during a median follow up time of 24 months (Q1-Q3: 8–55) months. Within the 12 items of the SDI there were 301 integument, 208 renal, 149 neuropsychiatric, 98 musculoskeletal, 88 cardiovascular, 65 ocular, 43 pulmonary, 42 peripheral vascular, 33 gastrointestinal, 22 premature gonadal failure, 16 diabetes and 9 malignancy. After adjusting for potential confounders, at any time during follow-up a patient on AMs had a 35% and 30% lower risk of renal and neuropsychiatric damage accrual respectively than a patient not on AMs (adjusted HR 0.65, 95% CI 0.47 to 0.90 and HR 0.70, 95% CI 0.48 to 1.02). Such protective effect was not evident for integument, musculoskeletal and cardiovascular damage. Table 1.

View this table:
Abstract CS-08 Table 1

Multivariable Cox proportional hazard model: time-to-items damage accrual

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

Acknowledgements On behalf of the Grupo Latinoamericano de Estudio del Lupus (GLADEL).

https://doi.org/10.1136/lupus-2018-lsm.43

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