Ab1798-Hpr foot Alterations in Systemic Lupus Erythematosus: A 1-Year Longitudinal Study

Abstract

BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease mediated by autoantibodies, with involvement of various organs[1,2]. El 95% of patients with SLE have musculoskeletal involvement[1], most often in the form of arthralgias or non-erosive arthritis affecting mainly the hands and knees. Although the feet are equally affected and can result in significant disability, they have been little studied.ObjectivesTo determine changes in foot involvement in patients with SLE after 12 months of follow-up.MethodsLongitudinal case series. Thirty-six subjects with a diagnosis of SLE were consecutively recruited in the Rheumatology Unit between March and June 2021 and followed up at 12 months. Inclusion criteria were: patients with a diagnosis of SLE according to EULAR/ACR 2019 criteria, with at least one year of evolution and age equal to or older than 18 years. A Rheumatology nurse collected information on socio-demographic data and the questionnaires at baseline and at 12 months. The questionnaires were: SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) and SLICC (Damage Index for Systemic Lupus Erythematosus), quality of life: EQ-5D, foot function: FFI (Foot Function Index), FAAM (Foot and Ankle Ability Measures Questionnaire), FAAM-Sport, FPI (Foot Posture Index). A descriptive analysis of the main variables, and a paired t-test or Wicoxon t-test, as appropriate, were performed between the baseline and 12-month follow-up visits.ResultsThirty-six patients with SLE (97.2% women) with a mean (SD) age of 49.31 (11.4) years with a range 23-66 years participated. Regarding treatment a total of 22/36 patients (66.2%) had immunosuppressive treatment, 4/36 (11.1%) biological therapy and 26/36 (72.2%) hydroxychloroquine treatment. After 12 months of follow-up, the disease remained stable and there were no significant differences in the SLICC and SLEDAI indices of SLE. There were also no significant differences in the different foot questionnaires administered: FAAM, FAAM-Sport, FPI, FFI after 12 months of evolution. There was only a worsening in VAS EQ5D (p=0.028) although there was no significant change in EQ5D (p=0.773) (Table 1).ConclusionIn SLE patients with stable disease over one year of follow-up, assessments of foot function and ability remain unchanged. It is important to integrate foot assessment into the joint evaluation because of the high impact on the patient’s quality of life and patient functionality.Table 1.Baseline (Mean± SD)12 months (Mean± SD)P valueEQ5D0,54±0,250,55±0,230,773EVAEQ5D66,43±21,6157,36±24,770,028FFI37,52±25,2336,24±25,290,965FAAM0,65±0,231,05±2,570,322FAAM-Sport0,51±0,280,57±0,280,779FPI rigth2,33±2,192,37±2,210,324FPI left1,36±1,851,37±1,880,248SLICC0,86±1,450,72±1,160,257SLEDAI1,44±1,941,02±1,870,117References[1] Cherry L, Alcacer-Pitarch B, Hopkinson N, Teh LS, Vital EM, Edwards CJ, et al. The prevalence of self-reported lower limb and foot health problems experienced by participants with systemic lupus erythematosus: Results of a UK national survey. Lupus. 2017 Apr;26(4):410-416.[2] Durcan L, O’Dwyer T, Petri M. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet. 2019 Jun 8;393(10188):2332-2343.Acknowledgements:NIL.Disclosure of InterestsNone Declared.