{
  "abstract": "Objectives We previously reported that patients who entered the UCLH lupus cohort between 2006-2011 had better survival in Kaplan-Meier analysis than those who entered earlier. There was some indication that improved outcomes might be related to changing patterns of drug use and clinical presentation in the group of patients recruited between 2006 and 2011. We wanted to extend the study to include later time groups in order to find out whether patients who were recruited between 2011 and 2020 also showed these patternsMethods We carried out detailed analysis of the medical and research records of 600 patients with SLE who had been recruited to the cohort between 1978 and 2020. The patients were divided into 20 groups of 30 on the basis of year of entering the cohort. For each group we noted the following outcomes; ever-use of cyclophosphamide, ever-use of mycophenolate, ever-use of biologics, symptoms at presentation and lifetime damage (yes/no). Damage was assessed using the Systemic Lupus International Collaborative Clinics Damage Index. The symptoms at presentation were classified as mild (mucocutaneous, musculoskeletal and/or changes in blood counts only) or severe (any other presentation).Results Figure 1 shows a decline in use of cyclophosphamide from 2013 onwards. Ever-use of mycophenolate began to rise from the group recruited from1994 onwards and biologics from 2001 onwards with plateau in ever-use in 50% of patients for mycophenolate and 40% for biologics in all groups recruited after 2009. Mild and severe presentations were roughly equal till 2015 after which > 60% of all new patients presented with milder features. Figure 2 shows a decline in lifetime damage starting after 2013, Whereas all groups recruited up to 2005 had > 60% prevalence of lifetime damage, all groups recruited after 2013 had < 30% prevalence of lifetime damage.Abstract PO:07:185 Figure 1–2Conclusions This long-term study suggests that patients entering this cohort of patients with SLE at a single centre have presented with milder manifestations and developed less lifetime damage over the past decade. The use of cyclophosphamide has fallen dramatically whereas ever-use of mycophenolate and biologics have risen to plateaus of about 50% and 40% respectively in patients recruited after 2009.",
  "authors": [
    {
      "affiliations": [
        "Centre for Ageing, Rheumatology and Regenerative Medicine, University College, London, London, UK"
      ],
      "name": "Anisur Rahman"
    },
    {
      "affiliations": [
        "Centre for Ageing, Rheumatology and Regenerative Medicine, University College, London, London, UK"
      ],
      "name": "Nidhi Rege"
    },
    {
      "affiliations": [
        "Centre for Ageing, Rheumatology and Regenerative Medicine, University College, London, London, UK"
      ],
      "name": "Maria Pisliakova"
    },
    {
      "affiliations": [
        "Centre for Ageing, Rheumatology and Regenerative Medicine, University College, London, London, UK"
      ],
      "name": "Gullu Uzun"
    },
    {
      "affiliations": [
        "Centre for Ageing, Rheumatology and Regenerative Medicine, University College, London, London, UK"
      ],
      "name": "David Isenberg"
    }
  ],
  "title": "PO:07:185 Patterns in clinical presentation and use of medications in 600 patients with SLE seen over a 40-year period",
  "uid": "649a8b7e-b575-5a7e-a0a9-a32bba5411e2"
}