O28 Unveiling the impact of neuropsychiatric involvement in systemic lupus erythematosus on damage accrual

Objective The link between neuropsychiatric involvement in systemic lupus erythematosus (NPSLE) and heightened morbidity, mortality, and organ damage, as well as detrimental impacts on health-related quality of life has been well-documented. However, the direct association between NPSLE and specific SLICC/ACR damage index (SDI) items, especially non-neuropsychiatric items, remains unclear. Herein, we sought to investigate the impact of NPSLE on organ damage accrual in a large lupus cohort. Methods We conducted an analysis of baseline data derived from five phase III trials (BLISS-52, BLISS-76, BLISS-SC, BLISS-NEA, EMBRACE), encompassing a total of 3645 SLE participants. NPSLE involvement was defined as NP BILAG A/B/C/D or scores on any of the NP SLEDAI-2K domains (n=372); the non-NPSLE group comprised patients with NP BILAG E and no neuropsychiatric involvement based on the NP SLEDAI-2K domains (n=3273). We employed univariable logistic regression analysis in case of Results The median/mean (IQR; SD) SDI score and SLE disease duration were 0; 0.62 (0–1; 1.09) and 4.51; 6.44 (1.56–9.32; 6.33) years, respectively. Compared with the non-NPSLE group, SLE patients with neuropsychiatric involvement had greater SDI scores (adjusted (a)OR: 2.70; 95% CI: 2.14–3.42; pConclusions The intricate association between neuropsychiatric involvement in SLE and damage accrual extends beyond the realm of the nervous system, impacting the musculoskeletal, skin, and cardiovascular organ systems. Prospective research, especially survey in non-selected real-world SLE cohorts, would be required to determine the causal relationship between NPSLE and the various components of the SDI. Clarifying this association would contribute to a more comprehensive understanding of the disease and facilitate more targeted management strategies for individuals affected by NPSLE.