Op0249 antiphospholipid Syndrome (Aps) in Systemic Lupus Erythematosus (Sle) Leads to a More Severe Disease

Abstract

BackgroundAntiphospholipid antibodies (aPL) have been associated with organ damage and certain features in SLE patients.ObjectivesOur aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome.MethodsPatients from the RELESSER-T registry were included. RELESSER-T is a multicenter, hospital-based registry, with retrospective cross-sectional collection of data from a large representative sample of adult non-selected patients with SLE attending Spanish rheumatology services from the public national health system.ResultsWe included 3651 SLE patients and 1368 were positive for aPL (44.9% of patients were positive for anticardiolipin antibodies, 27.3% showed positivity for anti b2glycoprotein I and 24% for lupus anticoagulant). Overall 2283 patients were classified as SLE no aPL, 528 as SLE-APS and 840 as SLE-aPL. Demographic data, clinical and laboratory features in the different groups are showed in Table 1. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than SLE-aPL and SLE no aPL patients (p< 0.001, p< 0.001 and p=0,022, respectively). SLE-APS patients showed a lower prevalence of photosensitivity and higher frequencies of serositis, proteinuria (>0.5 grs), urinary cell casts, seizures and psychosis (p≤0.001). Overall, SLE-APS patients showed a lower rate of cutaneous manifestations and higher rates of neuropsychiatric, cardiac, pulmonary, renal, joint and ophthalmological manifestations (Table 1). In accordance with a more severe clinical profile, higher frequency of anti-DNA antibodies and hypocomplementemia were observed in the SLE-APS group (p<0.001). In addition to a higher disease activity (SLEDAI), SLE APS patients presented more damage accrual with higher values in SLICC (1.9±2.2 in SLE APS, 0.9±1. 4 in SLE aPL and 1.1±1.6, p<0.001) and Katz indexes (3±1.8 in SLE APS, 2.7±1.7 in SLE aPL and 2.6±1.6 in SLE no aPL, p <0.001).ConclusionSLE-APS patients show a more severe clinical profile with higher frequency of major organ involvement and more damage accrual than SLE-aPL and SLE no APL.Disclosure of InterestsLeyre Riancho-Zarrabeitia Grant/research support from: Abbvie, Pfizer, UCB, MSD, GSK, Amgen, Roche travel grants, Victor Martinez Taboada: None declared, Iñigo Rua-Figueroa: None declared, Fernando Sánchez-Alonso: None declared, María Galindo-Izquierdo: None declared, Juan Ovalles: None declared, Alejandro Olivé Grant/research support from: ND, Consultant for: ND, Paid instructor for: ND, Speakers bureau: ND, Antonio Fernandez-Nebro: None declared, Jaime Calvo Consultant for: Bristol-Myers Squibb, Janssen, Celgene, Sanofi Genzyme, Speakers bureau: Bristol-Myers Squibb, Raúl Menor Almagro: None declared, Eva Tomero Muriel: None declared, Esther Uriarte Isacelaya: None declared, Alina Boteanu: None declared, Mariano Andres: None declared, Mercedes Freire González: None declared, Gregorio Santos Soler: None declared, Esther Ruiz Lucea: None declared, Mónica Ibañez Ba...

The assessment of patients with the antiphospholipid antibody syndrome: where are we now?

“…Thrombotic APS is a major predictor of irreversible organ damage and death in SLE patients (14,18,19). Moreover, the presence, type and titre of aPL influences the risk for clinical APS and confer a higher hazard for major organ involvement in SLE patients (20).…”