OA10 Survival analysis of 496 patients with systemic lupus erythematosus with up to 40 years follow-up shows improved survival in patients diagnosed in more recent time-periods

Abstract

Abstract Background/Aims Patients with systemic lupus erythematosus (SLE) have increased mortality compared to age- and sex-matched controls. Lupus nephritis (LN) is a severe manifestation of SLE and an important cause of death. Our objective was to carry out a retrospective survival analysis to investigate factors that could influence risk of mortality and LN in a large multi-ethnic cohort of patients with SLE. Methods By careful review of medical records, we identified 496 patients with SLE for whom we had complete information regarding period of observation and occurrence of death and nephritis. Patients were stratified into groups according to sex, ethnicity (Caucasian, African/Caribbean, South Asian, East Asian, Other), age at start of follow-up (above and below median) and time-period of diagnosis (1978-89, 1990-99, 2000-5, 2006-11). Kaplan-Meier analysis was used to investigate differences between the groups in survival and LN. Results Overall, there were 454 women and 42 men. 91 patients died and 165 developed LN. Mean follow-up was 15.8 ± 8.75 years with a maximum of 40 years. Median age at start of follow-up was 28.0 ± 12.13 years. Results are shown in Table 1 There were no differences between men and women in mortality or LN. Caucasian patients were significantly less likely to develop LN (P < 0.0001) than other groups but there was no mortality difference between ethnic groups. Patients diagnosed below age 28 were more likely to develop LN (P < 0.0001) but less likely to die (P = 0.0039) than those diagnosed above age 28. Patients diagnosed between 2006 and 2011 were significantly less likely to die than those diagnosed between 1978 and1989 by Cox proportional hazards analysis of survival curves. (P = 0.019) Conclusion In this long-term survival analysis of 496 patients, non-Caucasian patients and those diagnosed below the age of 28 years were more likely to develop LN. The latter group were less likely to die than those diagnosed at older ages. Survival curves for groups of patients diagnosed in successive time periods suggested improved survival over time. Disclosure W. Luo: None. F. Farinha: None. D.A. Isenberg: None. A. Rahman: None.