{
  "abstract": "Objectives High disease activity in systemic lupus erythematosus (SLE) significantly impacts life prognosis. Although complement C3, C4, and anti-dsDNA antibodies serve as conventional biomarkers for monitoring SLE activity being components of SLEDAI-2K, they may be insufficient in distinguishing high disease activity, particularly in patients with non-renal manifestations. This study aimed to compare the performance of inflammatory markers (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], interleukin-6 [IL-6]) with conventional biomarkers (C3, C4, anti-dsDNA) in distinguishing SLE patients with high disease activity.Methods Seventy-nine SLE patients (median age 37 [29-48] years; 86.1% female) were enrolled in cross-sectional study. Disease activity was assessed using SLEDAI-2K, with high activity defined as >10 points. Serum anti-dsDNA, C3, C4, ESR, CRP, and IL-6 levels were measured. Receiver operating characteristic (ROC) curves and logistic regression models were used to evaluate the diagnostic performance of biomarkers for identifying high disease activity.Results High disease activity was observed in 31 patients (39.2%), while 48 (60.8%) had mild-to-moderate activity. ESR and IL-6 levels were significantly higher in patients with high disease activity compared to those with mild-to-moderate SLE (29 [17-42] mm/h vs 15 [6-33] mm/h, and 6 [4-36] pg/ml vs 2 [1-7] pg/ml, respectively; p<0.05). CRP levels did not differ significantly between groups. SLEDAI-2K scores correlated with C3, C4, anti-dsDNA, ESR, and IL-6, but not with CRP. Based on ROC-analysis, IL-6 and ESR exhibited better parameters for determining high SLE activity compared to C3, C4, and anti-dsDNA ( table 1). The optimal cut-off point for IL-6 was 5.4 pg/ml with a sensitivity of 74.2% and specificity of 68.1%, whereas the cut-off point for ESR was 40 mm/h with a sensitivity of 41.4% and specificity of 92.7%. In multivariate logistic regression (AUC = 0.825), IL-6 level >5.4 pg/mL and ESR >40 mm/h were independent predictors of high SLE activity (OR 10.1, 95% CI 2.8-35.8, p=0.0004; OR 11.4, 95% CI 2.3-57.3, p=0.003, respectively).Abstract PO:02:052 Table 1Performance of biomarker models in determining high SLE activity (SLEDAI-2K >10 points).Conclusions The discriminatory performance of ESR and IL-6 in identifying high SLE activity is superior to complement and anti-dsDNA. These inflammatory markers may be used in routine clinical practice, alongside conventional biomarkers, to improve detection of high disease activity and facilitate appropriate therapeutic interventions.",
  "authors": [
    {
      "affiliations": [
        "Bogomolets National Medical University, Department of Internal Medicine #3, Kyiv, Ukraine"
      ],
      "name": "Oleg Iaremenko"
    },
    {
      "affiliations": [
        "Bogomolets National Medical University, Department of Internal Medicine #3, Kyiv, Ukraine"
      ],
      "name": "Daria Koliadenko"
    },
    {
      "affiliations": [
        "St. Michael’s Clinical Hospital, Clinical Diagnostic Laboratory, Kyiv, Ukraine"
      ],
      "name": "Kateryna Iaremenko"
    }
  ],
  "title": "PO:02:052 Performance of inflammatory biomarker models in determining high disease activity in systemic lupus erythematosus",
  "uid": "215b7a61-8c2f-534c-9411-6ca0009b09e1"
}