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Comparative study between two European inception cohorts of patients with early systemic lupus erythematosus
I. Prevete1, G. Espinosa2, F. Bellisai3, A. Bortoluzzi4, F. Conti5, M. Fredi6, E.M. Fonseca-Aizpuru7, V. García De Viedma8, A. González-García9, R. González-León10, L. Iaccarino11, F. Iannone12, A. Marín-Ballvé13, F. Mitjavila14, L. Pallarés15, M. Piga16, R. Ríos-Garcés17, S. Suárez18, C. Tani19, A. Zanetti20, G. Ruiz-Irastorza21, G.D. Sebastiani22
- Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
- Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain. gespino@clinic.cat
- U.O.C Reumatologia, Azienda Ospedaliera Universitaria, Siena, Italy.
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria Sant’Anna, Ferrara, Italy.
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Sapienza University of Rome, Italy.
- Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili di Brescia; Rheumatology, Department of Clinical and Experimental Science, University of Brescia, Italy.
- Department of Internal Medicine, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain.
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain.
- Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
- Rheumatology Unit, Department of Medicine, University of Padova, Italy.
- DETO-Section of Rheumatology Unit, University of Bari, Italy.
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
- Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
- Department of Internal Medicine, Hospital Universitario Son Dureta, Palma de Mallorca, Islas Baleares, Spain.
- Cattedra e Struttura Complessa di Reumatologia, University of Cagliari and Azienda Ospedaliero-Universitaria di Cagliari, Italy.
- Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain.
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
- Rheumatology Unit, Department of Clinical and Experimental Medicine, Università di Pisa, Italy.
- Centro Studi SIR (Società Italiana di Reumatologia), Epidemiology Unit, Italy.
- Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Bizkaia, Spain.
- Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
on behalf of Gruppo di Studio SIR sul Lupus Eritematoso Sistemico di recente insorgenza-Early Lupus and Registro Español de pacientes con Lupus Eritematoso Sistémico (RELES), Autoimmune Diseases Study Group (GEAS)
CER12525
2020 Vol.38, N°5
PI 0925, PF 0932
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PMID: 31969225 [PubMed]
Received: 23/06/2019
Accepted : 07/10/2019
In Press: 20/01/2020
Published: 02/10/2020
Abstract
OBJECTIVES:
To compare the main characteristics of two inception cohorts (Italian [ITC] and Spanish [SPC]) cohorts of patients with systemic lupus erythematosus (SLE) at the time of diagnosis and at one year of follow-up.
METHODS:
Demographic, clinical and immunological characteristics, and treatments at SLE diagnosis and at 12 months of follow-up of ITC and SPC were compared.
RESULTS:
One hundred and sixty-four patients in the ITC and 231 patients in the SPC were compared. the patients from ITC were younger at SLE diagnosis (41.1±15.0 years vs. 46.4±15.6 years; p<0.001) and had a higher prevalence of arthritis (62.8% vs. 45.5%; p=0.001), serositis (25.6% vs. 16.0%; p=0.026), neurological involvement (7.9% vs. 1.7%; p=0.006), and immunological abnormalities (anti-dsDNA, anti-Sm, antiphospholipid antibodies) (93.9% vs. 77.8%; p<0.001). Conversely, photosensitivity (29.5% in ITC vs. 45.9% in SPC; p=0.001) and oral ulcers (12.4% vs. 30.3%; p<0.001) were more frequent at onset of SLE in the Spanish patients. At the first 12 months of follow-up, these differences were maintained. At SLE onset, more Italian patients received glucocorticoids (85.4% vs. 50.2%; p<0.001) and immunosuppressive agents. At 12 months of follow-up, more Spanish patients were treated with antimalarials (75.6% in ITC vs. 90.0% in SPC; p<0.001). Conversely, the use of glucocorticoids was lower in SPC (89.0% in ITC vs. 57.1% in SPC; p<0.001).
CONCLUSIONS:
These cohorts presented different profiles in terms of pattern of organ/system involvement and disease treatment, possibly as a consequence of patient selection or different disease management approaches between Italy and Spain.