LAUSR

Background: The Systemic Lupus International Collaborating Clinics (SLICC) Frailty Index (SLICC-FI) has been developed as a predictor of outcomes in SLE patients1-3. It combines disease activity, damage, comorbidities and health-related quality of life measures. Objectives: To evaluate the SLICC-FI as a predictor of damage accrual in systemic lupus erythematosus (SLE) patients. Methods: Patients from a multi-ethnic, multi-center US lupus cohort were included. Damage was ascertained with the SLICC/American College of Rheumatology (ACR) damage index (SDI) at last visit. The first visit in which the SLICC-FI could be derived was considered as the baseline visit. Univariable and multivariable Poisson regression models were performed to determine the association between the baseline SLICC-FI and last SDI, adjusted for sex, age at diagnosis, ethnicity, insurance, prednisone daily dose, antimalarial and immunosuppressive drug use at baseline. Age and gender were included a priori in the multivariable model, the other variables were included if they had a p<0.10 in the univariable models. Results: Of the 503 patients included, 454 (90.3%) were female with mean (SD) age 37.1 (12.5) years at diagnosis; 174 (34.6%) were African-American, 144 (28.6%) were Caucasians, 86 (17.1%) Hispanics (Texas), and 99 (19.7%) were Hispanics (Puerto Rico). The mean (SD) baseline SLICC-FI was 0.26 (0.06). The final mean (SD) SDI score was 1.9 (2.2). Higher SLICC-FI scores at baseline predicted greater damage accrual in the univariable analysis [Estimate=5.058, (SE=0.498); p<0.0001]. The SLICC-FI remained associated with damage accrual in the multivariable model, after adjustment for possible confounders [Estimate= 3.561 (SE=0.538); p<0.0001]. Conclusion: The SLICC-FI predicts damage accrual in SLE patients from a multi-ethnic cohort, supporting the importance of this index in the evaluation of SLE patients, combining several aspects of the disease. References: [1]Legge A, Kirkland S, Rockwood K, et al. Construction of a Frailty Index as a Novel Health Measure in Systemic Lupus Erythematosus. J Rheumatol. 2020; 47: 72-81 [2]Legge A, Kirkland S, Rockwood K, et al. Evaluating the Properties of a Frailty Index and Its Association With Mortality Risk Among Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019; 71: 1297-107 [3]Legge A, Kirkland S, Rockwood K, et al. Prediction of Damage Accrual in Systemic Lupus Erythematosus Using the Systemic Lupus International Collaborating Clinics Frailty Index (SLICC-FI). Arthitis Rheumatol. Epub ahead of print 2019 Oct 21. Disclosure of Interests: Manuel F. Ugarte-Gil Grant/research support from: Jannsen, Pfizer, Jyoti Dubey: None declared, Gerald McGwin: None declared, Luis Vila: None declared, Graciela S Alarcon: None declared