2277: Patients with Systemic Lupus Erythematosus: A Comparative Study Between Two Large, Multi-centric, Spanish and Argentinian Registers, Focused on Outcomes Differences

Iñigo Rúa-Figueroa¹, Rosana M Quintana², JULIA MARTINEZ BARRIO³, Mercedes García⁴, Maria Galindo-Izquierdo⁵, Lucila Garcia⁶, Jaime Calvo- Alén⁷, Carla Gobbi⁸, Esther Uriarte Isacelaya⁹, Paula Alba⁸, Eva Tomero Muriel¹⁰, Verónica Bellomio¹¹, Mercedes Freire González¹², Susana Roverano⁶, Victor Martinez-Taboada¹³, Analia Patricia Alvarez¹⁴, Eva Salgado-Pérez¹⁵, Cesar Enrique Graf¹⁶, Paloma Vela¹⁷, Cecilia Pisoni¹⁴, Antonio Fernandez-Nebro¹⁸, Valeria Arturi¹⁹, Clara Sanguesa Gomez²⁰, Catalina Gomez¹⁴, Javier Narvaez²¹, Zulema Plaza²², Gregorio Santos Soler²³, Silvia Papasidero²⁴, José Ángel Hernández Beriain²⁵, Raul Paniego⁶, Angela Pecondón²⁶, Maria Celina De La Vega⁶, Oihane Ibarguengoitia-Barrena²⁷, Emma Civit⁸, Gema Bonilla²⁸, Luciana Gonzalez Lucero¹⁴, Vicente Torrente-Segarra²⁹, Maria Victoria Martire⁶, Ana Paula Cacheda³⁰, Rodrigo Aguila Maldonado¹⁴, Maria J. García-Villanueva³¹, Sergio Gordon¹⁴, Clara Moriano Morales³², Marina Micelli⁶, Loreto Horcada³³, Romina Nieto³⁴, Nuria Lozano Rivas³⁵, Gretel Rausch¹⁴, Guillermo Pons-Estel³⁴ and Jose-Maria Pego-Reigosa³⁶, ¹Rheumatology, Hospital de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain, ²Centro Regional de Enfermedades Autoinmunes y Reumticas (CREAR), Grupo Oroño, Rosario, Argentina, ³Rheumatology, Gregorio Marañon University Hospital, Madrid, Spain, ⁴Hospital Interzonal General de Agudos José de San Martín, La Plata, Argentina, ⁵Rheumatology, University Hospital of 12 de Octubre, Madrid, Spain, ⁶RELESSAR, CABA, Argentina, ⁷Rheumatology, Bioaraba Research Unit, Hospital Universitario Araba, Vitoria, Spain, ⁸RELESSAR, Cordoba, Argentina, ⁹Rheumatology, University Hospital of Donosti, San Sebastián, Spain, ¹⁰Rheumatology, Hospital La Princesa, Madrid, Spain, ¹¹RELESSAR, Tucuman, Argentina, ¹²Rheumatology department, Complexo Hospitalario Universitario A Coruña (CHUAC). Instituto de Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain, ¹³Rheumatology, Hospital Marqués de Valdecilla, Santander, Spain, ¹⁴Study Group of the Argentine Society of Rheumatology for Systemic Lupus Erythematosus, Buenos Aires, Argentina, ¹⁵Department of Rheumatology, University Hospital of Ourense, Ourense, Spain, ¹⁶RELESSAR, ENTRE RIOS, Argentina, ¹⁷Department of Rheumatology, University Hospital of Alicante, Alicante, Spain, ¹⁸Hospital Regional Universitario de Málaga, Malaga, Spain, ¹⁹RELESSAR, La Plata, Argentina, ²⁰Severo Ochoa Hospital, Madrid, Spain, ²¹Hospital Universitario de Bellvitge, Barcelona, Spain, ²²Universidad Autónoma de Madrid, Madrid, Spain, ²³Rheumatology, Hospital Marina Baixa Villajoyosa, Alicante, Spain, ²⁴Hospital General de Agudos Dr. Enrique Tornú, Buenos Aires, Argentina, ²⁵Rheumatology, Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain, ²⁶Hospital Universitario Miguel Servet, Zaragoza, Madrid, Spain, ²⁷Galdakao-Usansolo University Hospital, Bilbao, Spain, ²⁸Department of Rheumatology, Hospital Clínico Universitario La Paz, Madrid, Spain, ²⁹Department of Rheumatology, Hospital de Sant Joan Despí Moises Broggi,, Sant Joan Despí, Spain, ³⁰Department of Rheumatology, Hospital Son Llatzer, Palma de Mallorca, Spain, ³¹Hospital Ramón y Cajal, Madrid, Spain, ³²Rheumatology, Hospital Universitario de León, León, Spain, ³³Hospital de Navarra, Pamplona, Spain, ³⁴RELESSAR, Rosario, Argentina, ³⁵Department of Rheumatology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain, ³⁶Rheumatology, Hospital do Meixoeiro, Vigo, Spain

Background/Purpose: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multi-organ involvement, associated with substantial morbidity and mortality. A characteristic that distinguishes lupus patients is the aggressiveness of the disease, associated with worse outcomes, especially in certain ethnic groups. Patients of Afro-American ethnicity or Hispanics present more frequency of renal disease and higher damage accrual, as compared to Caucasians, and there is certain controversy regarding the factors that explain these differences and the relevance of the socioeconomic status on there. OBJETIVES: To compare the clinical and serological features, treatments, outcomes and comorbidities of SLE patients from the cross-sectional phase of the Spanish lupus registry (RELESSER), those Latin American patients residing in Spain, who belong to the RELESSER register and patients from the Argentinian register (RELESSAR).

Methods: RELESSER and RELESSAR are large multicenter registries and share the same database, with identical definitions of the variables. Likewise, both include patients who meet the ACR /1997 classification criteria. The variables collected were: demographics, clinical, serology, comorbidities and treatments; disease activity index (SELENA-SLEDAI), damage (SLICC/ACR Damage Index (SDI). The Charlson Comorbidity Index was performed as well as Katz score. In RELESSER, Latin American patients were defined as those born in Latin American countries, whose Latin American parents have emigrated to Spain. Other ethnic groups of RELESSER were excluded from this analysis. The categorical variables were compared using Chi-square test or Fisher's test, and for the continuous variables, ANOVA or the Kruskal Wallis test were carried out. In cases where significant differences were found between the groups, and multiple comparisons were performed. The significance level < 0.05 was considered. R software was used for data analysis.

Results: A total of 5423 patients were included: 1475 in the RELESSAR group, 3627 in the Caucasian RELESSER, and 208 Latin-American from RELESSER. Table 1 shows the multiple comparisons between the groups. Latin-American patients irrespective of the country in which they live have a younger age, shorter duration of the disease with a shorter time to diagnosis, higher severity as measured by Katz Index, more frequency of nephritis, higher SLEDAI and higher use of corticosteroids treatment. However, RELESSER patients had showed higher frequency of comorbidities and hospitalizations.

Conclusion: Latin-American patients had severe disease, with higher frequency of renal involvement and use of corticosteroids, no matter the countryof residence suggesting that health resources would not be a good explanation for these differences. However, Spanish Caucasian patients have more mortality and infection, probably linked to lesser use of antimalarials and high degree of comorbidity.






I. Rúa-Figueroa: AstraZeneca, 5, GSK, 1, 6; R. Quintana: None; J. MARTINEZ BARRIO: None; M. García: GSK, 6, Janssen, 6, Pfizer, 6; M. Galindo-Izquierdo: None; L. Garcia: None; J. Calvo- Alén: AbbVie, 2, AstraZeneca, 2, Biogen, 6, BMS, 5, Galapagos, 6, GSK, 2, 6, Lilly, 2, 6, Novartis, 2, 6, Roche, 5, Sanofi, 2; C. Gobbi: None; E. Uriarte Isacelaya: None; P. Alba: None; E. Tomero Muriel: None; V. Bellomio: None; M. Freire González: None; S. Roverano: None; V. Martinez-Taboada: None; A. Alvarez: None; E. Salgado-Pérez: None; C. Graf: None; P. Vela: None; C. Pisoni: None; A. Fernandez-Nebro: None; V. Arturi: None; C. Sanguesa Gomez: None; C. Gomez: None; J. Narvaez: None; Z. Plaza: None; G. Santos Soler: None; S. Papasidero: None; J. Hernández Beriain: None; R. Paniego: None; A. Pecondón: None; M. De La Vega: None; O. Ibarguengoitia-Barrena: None; E. Civit: None; G. Bonilla: None; L. Gonzalez Lucero: None; V. Torrente-Segarra: None; M. Martire: None; A. Cacheda: None; R. Aguila Maldonado: None; M. García-Villanueva: AstraZeneca, 6, GSK, 6, Otsuka, 1; S. Gordon: None; C. Moriano Morales: None; M. Micelli: None; L. Horcada: None; R. Nieto: None; N. Lozano Rivas: None; G. Rausch: None; G. Pons-Estel: None; J. Pego-Reigosa: None.