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Comparative study between two European inception cohorts of patients with early systemic lupus erythematosus


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

 

  1. Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
  2. Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain. gespino@clinic.cat
  3. U.O.C Reumatologia, Azienda Ospedaliera Universitaria, Siena, Italy.
  4. Rheumatology Unit, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliero-Universitaria Sant’Anna, Ferrara, Italy.
  5. Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Sapienza University of Rome, Italy.
  6. Rheumatology and Clinical Immunology Unit, ASST-Spedali Civili di Brescia; Rheumatology, Department of Clinical and Experimental Science, University of Brescia, Italy.
  7. Department of Internal Medicine, Hospital Universitario de Cabueñes, Gijón, Asturias, Spain.
  8. Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain.
  9. Department of Internal Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  10. Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
  11. Rheumatology Unit, Department of Medicine, University of Padova, Italy.
  12. DETO-Section of Rheumatology Unit, University of Bari, Italy.
  13. Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
  14. Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
  15. Department of Internal Medicine, Hospital Universitario Son Dureta, Palma de Mallorca, Islas Baleares, Spain.
  16. Cattedra e Struttura Complessa di Reumatologia, University of Cagliari and Azienda Ospedaliero-Universitaria di Cagliari, Italy.
  17. Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain.
  18. Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
  19. Rheumatology Unit, Department of Clinical and Experimental Medicine, Università di Pisa, Italy.
  20. Centro Studi SIR (Società Italiana di Reumatologia), Epidemiology Unit, Italy.
  21. Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Bizkaia, Spain.
  22. 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.

Rheumatology Article