CLINICAL MANIFESTATIONS AT DIFFERENT FOLLOW-UP TIME POINTS IN AUTOANTIBODY-DEFINED SLE SUBGROUPS.

PV179 / #524 Poster Topic: AS20 - Precision Medicine Background/Purpose The heterogeneity of SLE has impaired the advancement in diagnostic strategies, tailored treatments, and prognostic tools for this disease. Defining SLE subgroups based on autoantibody profiles can reduce such heterogeneity and reveal important differences.[1] Here, we studied a Norwegian inception cohort, with longitudinal follow-up at 2 years and 11 years (in median IQR[7-13]) after diagnosis. Methods We clustered 102 SLE patients, as previously,[1] based on 10 autoantibodies at diagnosis (Table 1, Figure 1A). The autoantibodies were measured using ELISA or immunoprecipitation, we assumed positivity if 1 of them was positive. Using logistic or linear regression, we tested associations between clusters and 13 clinical manifestations at diagnosis, 2-year, and last visit. We tested associations between the clusters and SLEDAI and some of its components: acute cutaneous lupus, cardiovascular disease, lung, or muscle-skeletal involvement for the last follow-up. Analyses were done in R v4.3.3. Table 1. Characteristics of the SLE cohort from Norway. Figure 1. Results Four clusters explained most variability based on the Silhouette index (Figure 1). The patients in subgroup 2 have a higher risk of photosensitivity at diagnosis (OR:12.5 95% CI:2.1-252.8) and 2 years after (OR:8.1 95% CI:1.7-76.8). In comparison, photosensitivity was less common in subgroup 3 compared to the rest of patients at 2 years (OR:0.3 95% CI:0.09-0.7) (Figure 2B). Acute cutaneous lupus was more frequent in subgroup 2 at the last visit (OR:3.7 95% CI:1.2-14.1), lung involvement was more frequent in subgroup 1 (OR:14.5 95% CI:11.4-543.2), although it did not reach significance (p-value=0.053). SLEDAI significantly differed among the subgroups at diagnosis being higher for subgroups 4 and 3 (respectively: OR:1.5 95% CI:1.3-1.8; OR:1.3 95% CI:1.1-1.5), conversely lower for subgroups 2 and 1 (respectively: OR:0.7 95% CI:0.6-0.9; OR:0.7 95% CI:0.6-0.8). At the last visit, SLEDAI was significantly lower for subgroup 3 (OR:0.7 95% CI:0.5-0.9). Figure 2. Conclusions Patients with SLE from Norway can be grouped into 4 based on their antibody profile at the time of the diagnosis. Regardless of the limited sample size, the observations indicate that antibody-defined subgroups are a tool to reduce SLE heterogeneity and improve perspective to study this disease. References: [1.] Diaz-Gallo LM. ACR Open Rheumatol 2022;4(1):27-39.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.