{
  "abstract": "Objectives Social determinants of health (SDH) influence outcomes in systemic lupus erythematosus (SLE), yet European data remain limited. This analysis examined the association between SDH (formal education level and perceived economic status) and perceived lupus control and other related outcomes among respondents of the Lupus Europe 2020 Survey.Methods In May 2020, Lupus Europe, the European umbrella patient association for SLE, ran a multilingual online survey for adults with a self-reported diagnosis of SLE living in Europe. We performed a post-hoc analysis of the anonymised survey data. Economic profile (difficulty paying monthly bills) and educational attainment (primary, secondary, academic) were used as SDH indicators and their associations with clinical, functional, and psychosocial outcomes were assessed using non-parametric and chi 2 tests. A multivariable logistic regression model estimated odds ratios (OR) of self-reported lupus control (past 3 months) associated with SDH, adjusting for age and sex.Results Among 4 157 respondents (median age 45 years; 96% female), 70% were White and 93% had more than primary education ( table 1). Economic hardship was common: 45.2% reported occasional, frequent, or constant difficulty paying bills. Higher economic difficulty was significantly associated with longer diagnostic delay and prior diagnosis of fibromyalgia or mental health disorder. It associated with poorer mobility, self-care, and daily-activity scores, greater fatigue, and more frequent use of antidepressants, anxiolytics, and oral corticosteroids (all p < 0.001). Educational attainment correlated with functional status but not with treatment. In multivariable analysis, financial difficulty remained an independent predictor of worse disease control (table 2). Compared with respondents without financial difficulties, odds of reporting lupus under control were lower by 39%, 58%, and 62% for those with occasional, frequent, and constant difficulties, respectively (all p < 0.001). The OR associated with primary education was below 1 but not statistically significant.Abstract PO:07:194 Table 1–2Conclusions Reported economic difficulties were independently associated with poorer perceived lupus control. In univariate analyses, economic hardship was also linked to reduced functional scores, higher steroid use, and delayed diagnosis, while lower educational level was associated only with reduced functional scores. These findings highlight the need to integrate socioeconomic screening and support strategies into comprehensive SLE management and policy frameworks.",
  "authors": [
    {
      "affiliations": [
        "UDAI – Autoimmune Diseases and Immunology Unit, ULS Tâmega e Sousa, Penafiel, Portugal",
        "UMIB – Unit for Multidisciplinary Research in Biomedicine, ICBAS School of Medicine, University of Porto, Porto, Portugal",
        "i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal"
      ],
      "name": "Daniel Guimarães De Oliveira"
    },
    {
      "affiliations": [
        "Lupus Europe, Brussels, BELGIUM"
      ],
      "name": "Zoe Karakikla-Mitsakou"
    },
    {
      "affiliations": [
        "Lupus Europe, Brussels, BELGIUM"
      ],
      "name": "Jeanette Andersen"
    },
    {
      "affiliations": [
        "Lupus Europe, Brussels, BELGIUM"
      ],
      "name": "Francesca Marchiori"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Elizabeth Arkema"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France"
      ],
      "name": "Laurent Arnaud"
    },
    {
      "affiliations": [
        "Lupus Europe, Brussels, BELGIUM"
      ],
      "name": "Alain Cornet"
    }
  ],
  "title": "PO:07:194 Socioeconomic inequalities and lupus control: insights from the lupus Europe 2020 survey",
  "uid": "aeb24203-7cb3-5339-8237-a5a9ce1064a9"
}