gms | German Medical Science

Introduction: Systemic Lupus Erythematosus (SLE) is a severe autoimmune disease that can affect various organ systems. Characterized by a misguided immune response, Lupus can cause a range of symptoms that can vary significantly from one patient to another.

The aim of this project is to compile clinical data of patients that have been treated in the University Hospital of Erlangen.

Methods: In total, we identified 359 patients fulfilling the American College of Rheumatology and/or the SLICC criteria for Systemic Lupus Erythematosus. Of these, 83% were female and 17% male, corresponding to a female-to-male ratio of 5:1. Demographics, treatment, clinical manifestations, serology, disease activity and the SLICC damage index were recorded in REDCap. The presence of these features was categorized as absent, historical, or at the time of sampling (i.e., at the last presentation). Additionally, serological markers (C3, C4, and anti-dsDNA) were documented at the last presentation and, when available, at the time of diagnosis.

Results: To date, data from 102 patients has been fully analyzed. The age at lupus diagnosis was 32.7 ± 14.4 years (mean ± standard deviation). The most observed clinical classification criterion was malar rash (63.7%) followed by photosensitivity (58.8%), synovitis (49%) and non-scarring alopecia (33.3%). Lupus Nephritis occurred in 22.5% of patients. The most frequent histological pattern in patients with biopsy proven Lupus Nephritis was class III/IV (69.6%). Class II was diagnosed in 13% of patients, 8.6% of patients had mixed pattern. Neuropsychiatric manifestations were observed in 8.8% of patients. Cytopenia occurred in 34.3% of patients with leukopenia (28.4%) being the most common manifestation. The most prevalent non criteria feature was Raynaud Syndrome (35.3%), followed by Sicca Symptoms (20.6%). Low complement and high titers of anti-dsDNA autoantibodies were detected during the course of the disease in 86.3% respectively 77.5%. At last presentation, 40.2% scored £ 1 in the SLEDAI2K, 92.2% scored £ 4 and 7.8% scored > 4. The maximum score was 24. Disease activity was distributed as follows: 48.8% of patients achieved DORIS remission, 43.2% attained low disease activity, 12.1% had persistent activity and 4.2% of patients had a flare. Irreversible organ damage, defined as a SLICC damage score of 1 or more, was present in 54.9% of patients with valvular disease (12.7%) being the most common SLICC damage score item. At the last evaluation, a total of 18.6% of patients were on biologic therapies: Belimumab (13.7% at sampling, 13.7% in the past), Rituximab (3.9% at sampling, 9.8% in the past) and Anifrolumab (1% at sampling, 1% in the past). 73.5% of patients were receiving Hydroxychloroquine, 18.6% Azathioprine, 15.7% Mycophenolate Mofetil and 11.8% Methotrexate. Historically, 19.6% received Cyclophosphamide.

Conclusion: We established a cross sectional, single center cohort of SLE patients as foundation for further clinical analysis.

Disclosures: There are no conflicts of interest in the context of the work shown.