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Treatment

 

Do antimalarials protect against damage accrual in primary Sjögren’s syndrome? Results from a Latin-American retrospective cohort

1, 2, 3, 4, 5, 6, 7, 8

 

  1. Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Subirán, Mexico City, Mexico.
  2. Department of Rheumatology, Hospital Universitário Cassiano Antonio de Moraes, Universidade Federal do Espírito Santo, Brazil.
  3. Department of Rheumatology, Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
  4. Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Subirán, Mexico City, Mexico.
  5. Department of Rheumatology, Hospital Universitário Cassiano Antonio de Moraes, Universidade Federal do Espírito Santo, Brazil.
  6. Department of Rheumatology, Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
  7. Department of Rheumatology, Hospital Universitário Cassiano Antonio de Moraes, Universidade Federal do Espírito Santo, Brazil.
  8. Department of Rheumatology, Hospital Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina. acapellet@gmail.com

CER10968
2018 Vol.36, N°3 ,Suppl.112
PI 0182, PF 0185
Treatment

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PMID: 29745873 [PubMed]

Received: 14/11/2017
Accepted : 01/02/2018
In Press: 19/04/2018
Published: 14/08/2018

Abstract

OBJECTIVES:
To assess the use of antimalarials and to evaluate their association with damage accrual in a Latino-American cohort of patients with primary Sjögren’s syndrome (pSS).
METHODS:
We included 377 patients attending three tertiary referral centers from: Argentina (n=110), Brazil (n=49) and Mexico (n=218). We retrospectively registered demographics, disease duration and use of prednisone (PDN), immunosupressors and antimalarials. We scored the cumulative ESSDAI and the SSDDI at last follow-up.
RESULTS:
Most patients were females, median disease duration 6 years, mean SSDDI score 2.7±1.8, mean cumulative ESSDAI score 9.3±8.3, 39% used PDN and 37.4% immunosupressors. A total of 191 patients (50.6%) had ever used antimalarials, mean use 43.5±40 months, being the main indication arthritis. These patients had a longer disease duration, used more PDN and immunosupressors and had lower SSDDI scores. The pleuro-pulmonary domain was significant different among groups (6.7% antimalarials users vs.14.9% not users, p=0.01). At the logistic regression, the pleuro-pulmonary domain (OR 0.37, 95% CI 0.17-0.78, p=0.01), the age (OR 0.97, 95% CI 0.96-0.99, p=0.01) and the disease duration (OR 1.07, 95% CI 1.03-1.1, p=0.0001) were associated with antimalarials use. When we compared patients with a SSDDI ≥3 vs. SSDDI<3, in the multivariate analysis the use of antimalarial was protective (OR 0.58, 0.36-0.93 CI 95%, p=0.02) and the cumulative ESSDAI a risk factor for damage accrual (OR 1.1, 1.07-1.15 CI 95%, p<0.001).
CONCLUSIONS:
Antimalarials were frequently used in pSS and seemed to protect against damage accrual, specifically at the pleuro-pulmonary domain. This finding should be confirmed in prospective studies.

Rheumatology Article