AB0567 DISEASE PATTERN IN EARLY AND NON-EARLY SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with a high degree of variability at onset, creating challenges in the accurate estimation of it’s pattern in early stages1. Objectives: To evaluate the pattern of the disease in patients with early and non-early systemic lupus erythematosus from physician’s perspective. Methods: Performed case-control study included SLE patients that fulfilled SLICC classification criteria, 2012. The research included two groups: patients with early SLE – 1st group (disease duration ≤24 months) and non-early SLE – 2nd group (disease duration ≤24 months). The pattern of the disease activity was assessed by SLEDAI-2K, SLAM, PGA and PhGA for SLE activity, SLICC/ACR DI for disease irreversible changes and SF-8 for the quality of life (QoL). We correlated disease activity scores within groups and activity indices with the QoL using intra- and inter-class correlation coefficients Results: A total of 101 SLE patients was analyzed. First group (early SLE) included 34 patients while the second group (non-early SLE) included 67 patients. The disease duration ± SD (range) was 12,42±8,70 (0.1-24) and 146,41±81,64 (31-432) months, respectively. The disease activity was high in both groups. The QoL was appreciated as low, compared to general population, by both components, in 2 groups. The damage index was higher in the 2nd group, which can be explained by longer disease duration and development of irreversible changes during the course of lupus. The PhGA showed stronger and higher correlation with disease activity and QoL in patients with longer disease duration. These can be explained by the more accurate assessment of patients that have longer disease duration, while the unpredictable evolution and the assessment of early SLE is being challenging for the physician. Also, physician’s judgment was influenced by the presence of irreversible organ damage in patient with longer disease, while in early disease course they where concerned mostly about disease activity. Conclusion: The clinical picture of SLE was characterized by high disease activity and low QoL in both, early and non-early lupus, while occurrence of irreversible organ changes was more characteristic for the longer disease. The disease parameters (activity, damage and QoL) correlated with PhGA mostly in patients with non-early SLE, the appreciation of the disease pattern being challenging in the early disease course.