SYSTEMIC LUPUS ERYTHEMATOSUS IN A RUSSIAN COHORT: TRIGGERS AND DISEASE SEVERITY AT ONSET

PV234 / #107 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose Systemic lupus erythematosus (SLE) is a chronic heterogenic autoimmune disease affected by several genetic and environmental factors, whose incidence has been shown to vary with sex, ethnicity and global region. The aim of this study was to describe any provoking factors and disease severity in a Caucasian SLE cohort at the Russian rheumatology center. Methods This observational retrospective-prospective study included 140 patients (88% women, median aged 34 [26;41] years (median [interquartile range 25;75%]), with SLE (SLICC 2012criteria) attending a routine visit at our Clinic between February 2021 and June 2024. Disease at diagnosis was categorized as Mild, Moderate or Severe, based on SLE Disease activity index (SLEDAI-2K): SLEDAI-2K≤4 – Mild, SLEDAI-2K=5–10 - Moderate, SLEDAI-2K≥11 - High activity (Severe disease). Results SLE was diagnosed at median age 26[19;34] years, and the age of the first SLE manifestations was 23 [17;31] years, the period duration between the first symptoms and SLE diagnosis was 12[5;48] months. The median of SLE duration was 3 [0,3;12] years, the median of SLEDAI-2K score at the time of inclusion – 8 [4;11] score, Systemic Lupus International Collaborating Clinics damage index (SDI) – 0 [0;1] score. Positive family history of immune-inflammatory rheumatic diseases (IIRD) among the first-line relatives was found in 11% of SLE patients. In the most patients, there were no connection with any provoking factors and SLE onset - 56%, in 15% of patients - with ultraviolet radiation/insolation, in 14% - with infection, in 10% - with pregnancy, in a few patients (1-2%) - with combined oral contraceptives use, stress, vaccination and trauma. At the time of SLE diagnosis the most patients had Moderate (SLEDAI-2K=5-10 points) and Severe/high (SLEDAI-2K≥11 points) activity: 41% and 35%, respectively. Mild disease (SLEDAI-2K=0-4 points) was identified in 24% of SLE patients. Conclusions In the Russian cohort, as in the general population, young women predominated. SLE was diagnosed about a year after the first manifestations. In the majority of cases, there was no specific trigger factor, the most frequently identified were: positive family history of IIRD, ultraviolet radiation/insolation, infections and pregnancy. In 76% of SLE patients the disease onset was characterized by moderate and high severity.

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