LAUSR

Background: Socioeconomic factors have been considered as possible confounding factors in the attribution of greater damage accrual in Afro-Caribbean and Hispanic patients with Systemic lupus erythematosus (SLE). Patients with SLE often experience long-term morbidity that can adversely affect their health-related quality of life (HRQoL)1 Objectives: To analyze the relation between socioeconomic status, damage accrual and HRQoL Methods: Analytic study in a cohort of SLE patients that were closely monitored in an autoimmunity program in Colombia. We stratified patients with damage (SDI ≥1) and no damage (SDI <1) and according to socioeconomic status as a surrogate value for economic income with dichotomization in low and medium/high income. We performed a non-parametric analysis of related simples of Wilcoxon in each of the dimensions of quality of life in EuroQoL 5d Results: We analyzed 400 Colombian patients. Baseline median age was 49 years (15 IQR) with median age at diagnosis and disease duration of 37 years (17 IQR) and 9 years (13 IQR) respectively. There were 94% female patients and 17.3% late onset SLE. Most frequent clinical manifestations were hematological (82.8%), mucocutaneous (75.3%) and nephritis (33.8%). Only 4.5% had neurological involvement. The mean SLEDAI were 1.18 and 0.65 at first and second measurement respectively, in the first measurement 97.1% of the patients had a SLEDAI ≤4. The mean SDI was 0.7275 at first measurement and 0.985 at the second measurement. When comparing the intervention in patients with SDI≥1 there was a significative improvement in the Quotidian Activities, Pain/Discomfort, Anxiety/Depression domains, independent of economic income. In patients with medium-high income there was also a significative improvement in the mobility and personal care domains. In the no-damage groups there was only a positive impact in the Anxiety/Depression domain in a statistically significant manner, and the medium-high income subgroup had improvement in the Pain/Discomfort domain. We didn’t find other statistically differences in the other domains. Low economic income seems to exert a negative influence in the different HRQoL domains with independence regarding treatment strategy, specially in patients with no damage accrual. In patients with higher income and damage accrual the opposite seems to appear, which could be related with a better ability or resources to cope with the consequences of the disease Conclusion: In Colombian patients with SLE, socioeconomic status (as a reflection of income) might be related with HRQoL. This relationship could be influenced by damage accrual Reference [1] Panopalis P, Petri M, Manzi S, Isenberg DA, Gordon C, Senecal JL, et al, and the Tri-Nation Study Group. The systemic lupus erythematosus Tri-Nation study: cumulative indirect costs. Arthritis Rheum2007;57:64–70 Damage present Damage absent Low incoming Mid -high incoming Low incoming Mid -high incoming Initial (%) Final (%) p Value † Initial (%) Final (%) p Value † Initial (%) Final (%) p Value † Initial (%) Final (%) p Value † Mobility 1 2 3 51481 55450 0,4 56,642,21,2 72,327,70 0,004 54,344,80,9 60,337,91,7 0,35 59,240,80 68320 0,13 Personal Care 1 2 3 7227,11 76230 0,35 73,524,12,4 84,315,70 0,016 72,426,70,9 76,721,61,7 0,5 78,821,20 79,820,20 0,85 Quotidian Activities 1 2 3 51,544,34,1 67330 0,005 59,836,63,7 73,225,61,2 0,03 60,338,80,9 62,931,95,2 0,7 65341 68,930,11 0,5 Pain/ Discomfort 1 2 3 3439,226,8 38,153,68,2 0,008 30,150,619,3 44,649,46 0,003 37,941,420,7 30,252,617,2 0,5 23,153,823,1 40,447,112,5 0,002 Anxiety/ Depression 1 2 3 5132,316,7 70,8227,2 0,001 6126,812,2 79,318,32,4 0,001 51,335,413,3 66,427,46,2 0,01 53,932,413,7 73,523,52,9 0,001 † Wilcoxon test Disclosure of Interests: None declared