DRUG-INDUCED LUPUS: CLINICAL AND SEROLOGICAL FEATURES IN A TERTIARY HOSPITAL
Bibliographic record
Abstract
PV218 / #452 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose Several drugs have been implicated in the development of de novo systemic lupus erythematosus (SLE), unmasking of quiescent SLE or causing an exacerbation of previously diagnosed SLE. Our aim is to describe the causative drugs, clinical and serological features of patients diagnosed of Drug-Induced lupus (DIL) in our Rheumatology Department Methods A total of 445 patients diagnosed with SLE treated in our Rheumatology Department from 2012 to 2023 were retrospectively screened for the fulfillment of DIL criteria through the search of medical electronic records. Demographic, clinical and laboratory data were summarized using descriptive statistics. Results We identified 18 patients diagnosed with DIL, representing a prevalence of 4% among all SLE patients in our Department. There was a female preponderance and a young age at disease onset. Only 3 drugs (infliximab, adalimumab and sulfasalazine) were identified as causative agents of DIL, anti-TNF being the most common. Most patients were treated for a condition different from a rheumatic disease, mainly inflammatory bowel disease (IBD). Median time to symptom onset after drug initiation ranged from 3 to 194 weeks (median 50.4). Peripheral arthritis and skin rash were the most frequent symptoms, with 4 patients (22%) presenting both at onset. Serologically, only 2 patients were ANA negative, but tested positive for anti-dsDNA. After drug withdrawal, ANA titer showed a slow decreasing trend over time, as well as anti-dsDNA antibodies. However, only 2 patients lost ANA positivity through follow-up. Remarkably, more than half of the patients tested positive for antiphospholipid antibodies. Conclusions DIL showed a prevalence of 4% in our Rheumatology Department. Anti-TNF agents were the most common drugs causing DIL. ANA tend to decrease over time, but only become undetectable in a few patients. Antiphospholipid antibodies are common in our DIL patients. Age at onset is earlier than previously reported, probably because causative drugs are being used in younger populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".