{
  "abstract": "Objectives Flares may still occur after remission, affecting organ damage accrual and survival expectancy. Therefore, identifying predictors of these flares is clinically relevant, particularly in Mestizo patients, for whom such evidence remains scarce. The aim of this study was to evaluate potential predictors of flares in primarily Mestizo SLE patients after they had achieved remission.Methods Data from a single-center prevalent Latin American SLE cohort were examined. The DORIS definition of remission was used as an entry criteria: a clinical SLEDAI-2K (excluding serology) = 0, prednisone less or equal than 5 mg/day, stable maintenance immunosuppression doses and/or biologic therapy, and physician global assessment (PGA) < 0.5. Flare was defined as an increase in SLEDAI-2K of at least 4 points (excluding those flares based only on serology). Potential predictors included sociodemographic characteristics, clinical variables (including SLEDAI-2K, SLICC/ACR damage index [SDI], PGA (per 0.1 increase) and the age-adjusted Charlson Comorbidity Index [ACCI]) and treatments. Univariable and multivariable regression analyses (stepwise selection procedure, alpha to stay in the model of 0.05) were used to identify independent predictors of flares.Results A total of 434 SLE patients who have at least presented remission once were included, contributing 1,547 visits during their follow-up; 93.1% were female, 97.9% were Mestizo, with a mean disease duration of 8.0 (6.8) years. The mean PGA was 0.05 (0.1), the mean SDI 1.4 (1.6) and the mean ACCI 1.5 (1.5). The mean prednisone dose was 3.2 (2.2) mg/day. During follow-up, 88 flares occurred (5.6% of all visits). In the multivariable analyses, higher PGA scores (HR 1.22; 95% CI 1.01–1.48; p=0.002), neuropsychiatric involvement (HR 1.89; 95% CI 1.20-2.98; p=0.006), African-Latin American ethnicity (HR 15.73; 95% CI 3.83–64.63; p<0.001) were independently associated with an increased risk of flares. Higher ACCI (HR 0.72; 95% CI 0.61–0.85; p<0.001) was associated with a lower risk of flares ( table 1).Abstract LBA:01:16 Table 1Predictors of flares in SLE patients after achieving remission from a predominant Mestizo cohortConclusions For those patients who achieve remission, a higher PGA score, previous neuropsychiatric involvement and African-Latin American ethnicity predicted an increased risk of SLE flares, whereas greater comorbidity burden was associated with fewer flares. Achieving a deeper state of remission may offer more protection against future flares.",
  "authors": [
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Benny Rashuamán-Conche"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Científica del Sur – Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémica, Lima, Peru"
      ],
      "name": "Rocío Violeta Gamboa-Cardenas"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Científica del Sur – Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémica, Lima, Peru"
      ],
      "name": "Victor Román Pimentel-Quiroz"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Alvaro Oyarce-Calderón"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Nadja Katyushka Ludeña-Sanchez-Huamanvilc"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Samira Garcia Hirsh"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Claudia Elera-Fitzcarrald"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Cristina Reategui-Sokolova"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru"
      ],
      "name": "Julio Alejandro Cerna-Lopez"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Nacional Mayor de San Marcos – School of Medicine, Lima, Peru"
      ],
      "name": "Cesar Pastor-Asurza"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Nacional Mayor de San Marcos – School of Medicine, Lima, Peru"
      ],
      "name": "Zoila Rodriguez-Bellido"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Nacional Mayor de San Marcos – School of Medicine, Lima, Peru"
      ],
      "name": "Risto Perich-Campos"
    },
    {
      "affiliations": [
        "Amsterdam University Medical Centers – Department of Rheumatology, Amsterdam, Netherlands"
      ],
      "name": "Ronald van Vollenhoven"
    },
    {
      "affiliations": [
        "The University of Alabama at Birmingham – Marnix E. Heersink School of Medicine, Birmingham, Alabama, USA",
        "Universidad Peruana Cayetano Heredia – School of Medicine, Lima, Peru"
      ],
      "name": "Graciela S Alarcón"
    },
    {
      "affiliations": [
        "Hospital Guillermo Almenara Irigoyen – Rheumatology Department, Lima, Peru",
        "Universidad Científica del Sur – Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémica, Lima, Peru"
      ],
      "name": "Manuel F Ugarte-Gil"
    }
  ],
  "title": "LBA:01:16 Predictors of flares in systemic lupus erythematosus patients after they had achieved remission. Data from the Almenara lupus cohort",
  "uid": "f32c42f7-daba-5545-a308-817beba4d22d"
}