{
  "abstract": "Objectives To describe patterns of glucocorticoid (GC) use, co-morbidities and infections in an ethnically diverse SLE population from a single UK city-region using a population-based primary care record.Methods All patients with SLE were identified from the Greater Manchester Care Record (GMCR), a large integrated electronic health record covering ~3 million residents. GC exposure was categorised by annual prescriptions: never, rare (<1/year), intermittent (1–<3/year), and frequent (>3/year). Current medical therapy was defined as a prescription record within primary care, in the preceding 3 months. Associations between GC use, comorbidities, infections, and demographics were assessed using multivariable negative binomial regression.Results We identified 2,727 SLE patients (88% female; median age 57 years [IQR 43–68]; 68% White, 18% Asian, 7% Black), median disease duration was 13.2 years (IQR 6.2–22.8). The point prevalence of SLE was 97.4 per 100,000 population. The median (IQR) deprivation index was 3.0 (2.0-7.0), table 1. Hydroxychloroquine (HCQ) and DMARDs were currently prescribed to 38.4% and 17.4%, respectively. Hypertension (22.7%) and type 2 diabetes mellitus (9.2%) were the commonest cardiometabolic comorbidities.GC use patterns were broadly stable across follow-up, with 658 (24%) receiving frequent GC therapy (figure 1). Higher GC exposure was associated with increased comorbidity burden with each additional annual prescription associated with a higher odds of chronic kidney disease (IRR 1.42, 95%CI 1.11–1.83, p<0.01), type 2 diabetes (IRR 1.57, 95%CI 1.22–2.04, p<0.001), hospitalisation for infection (IRR 1.43, 95%CI 1.17–1.79, p<0.001) and primary care managed infections (IRR 1.48, 95%CI 1.32–1.67, p<0.001). Black (OR 1.92, 95%CI 1.42–2.63, p<0.001) and Mixed ethnicity patients (OR 3.05, 95%CI 1.78–5.78, p<0.001) had higher odds of GC prescriptions compared to White patients.Abstract PO:03:083 Table 1clinical features by glucocorticoid use categoryAbstract PO:03:083 Figure 1oral glucocorticoid (GC) use over time from SLE diagnosisConclusions In this diverse primary care-based SLE cohort, comorbidities and infections were common. GC use was frequent, but we found low rates of HCQ prescribing. Higher steroid exposure was more frequent in Black and Mixed ethnicity patients and was associated with higher comorbidity and infection burden. A whole population approach to optimising SLE management beyond the specialist clinic will be needed to improve outcomes for all SLE patients.",
  "authors": [
    {
      "affiliations": [
        "The University of Manchester, Centre for Musculoskeletal Research, Manchester, UK"
      ],
      "name": "Sarah Dyball"
    },
    {
      "affiliations": [
        "The University of Manchester, Centre for Musculoskeletal Research, Manchester, UK"
      ],
      "name": "Mia Rodziewicz"
    },
    {
      "affiliations": [
        "Manchester University NHS Foundation Trust, The Kellgren Centre for Rheumatology, Manchester, UK"
      ],
      "name": "Ben Parker"
    },
    {
      "affiliations": [
        "Queen’s University Belfast, Faculty of Medicine, Health and Life Sciences, Belfast, UK"
      ],
      "name": "Ian N Bruce"
    }
  ],
  "title": "PO:03:083 Comorbidities, infections, and glucocorticoid sse in an ethnically diverse systemic lupus erythematosus (SLE) cohort: insights from a single UK city-region",
  "uid": "3c995062-b5c9-5d3b-8452-2359f7702300"
}