E124 Presentation, management and development of damage in 615 patients with systemic lupus erythematosus recruited over 40 years - effects of sex and ethnicity

Abstract Background/Aims Studies in many units have looked at associations of sex and ethnicity with clinical manifestations and outcomes in patients with systemic lupus erythematosus (SLE). Some reports have suggested that male patients have a more severe form of disease than female patients but small numbers hamper analysis. Non-white patients have worse outcomes in some studies but this may be partly related to socio-economic factors such as access to healthcare. In previous studies of our large lupus cohort, we found no difference related to ethnicity or sex in terms of survival but non-white patients were more likely to develop nephritis. In this study, we looked at manifestations on presentation to our unit, use of immunosuppressant medications and development of damage. Methods The Lupus Clinic at University College London Hospital has been running since 1978. We carried out detailed analysis of the medical and research records of 655 patients with SLE who had been recruited between 1978 and 2023. Forty patients were excluded because they were only followed up for a very short time and/or because key information was not available. For the remaining 615 patients, ethnicity was classified as Caucasian, Afro-Caribbean, South Asian, East Asian or Mixed Race/Other. Sex was classified as male or female. The five outcome measures analysed were ever-use of cyclophosphamide, mycophenolate or biologics, lifetime damage and manifestations at presentation. 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). Differences between groups were analysed statistically using the Chi squared test. Results There were 54 male and 561 female patients. The breakdown of ethnicity was Caucasian 329, Afro-Caribbean 132, South Asian 89, East Asian 42, Mixed Race/Other 23. The outcome measures are shown in Table 1. Conclusion Male patients had more severe manifestations and developed more damage but did not differ in terms of use of medications. Caucasian patients had less severe manifestations at presentation and were less likely to be treated with cyclophosphamide, mycophenolate or biologics but developed more damage. Disclosure M. Pisliakova: None. N. Rege: None. G.S. Uzun: None. R. Abida: None. D.A. Isenberg: None. A. Rahman: None.