VALIDATION OF A SCORE FOR THE PREDICTION OF SERIOUS INFECTION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: DATA FROM A LATIN AMERICAN LUPUS COHORT

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PV230 / #447 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose Patients with systemic lupus erythematosus (SLE) are at increased risk of serious infections, which in turn, are associated with morbidity and mortality. The Systemic Lupus Erythematosus Registry of the Spanish Society of Rheumatology (RELESSER) group has developed and internally validated a tool for prediction of severe infections in SLE, with a recently improved version (SLE Severe Infection Score-Revised or SLESIS-R),[1] being an accurate and reliable instrument. SLESIS-R includes age, previous SLE-related hospitalization, previous serious infection, and glucocorticoid dose. This study aimed to validate SLESIS-R in a multiethnic, multinational Latin American (LA) SLE cohort. Methods GLADEL 2.0 is an observational cohort from 10 LA countries of patients ≥ 18 years of age who fulfilled the 1982/1997 American College of Rheumatology (ACR) and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria. Patients with sufficient data at baseline and first annual visits were included. The outcome variable was any serious infection during the first year of follow-up that led to hospitalization. Baseline demographics and clinical manifestations, disease activity (SLEDAI-2k), SLICC/ACR Damage Index (SDI) and treatments were examined. Logistic regression was used to examine the predictive effect of baseline variables on the development of serious infection in the first year of follow-up. Receiver operator characteristics (ROC) analysis was used to define the area under the curve (AUC) for SLESIS-R. The cut-off point with the best validity parameters (sensitivity and specificity) was identified. Results Of the 1016 patients who completed 1-year follow-up, 208 (20.4%) had serious infections. Patients with serious infections were older, predominantly male, and had a longer disease duration (Table 1). This group had more frequent general, cardiac, pulmonary, hematological and gastrointestinal involvement at baseline and had a higher SDI and higher proportion of previous hospitalization. Univariate and multivariate analyses show variables associated with serious infection: disease duration, pulmonary and gastrointestinal involvements, and baseline glucocorticoid use (Table 2). The AUC for the SLESIS-R score was 0.922 (0.903-0.940). A score of 7 was chosen as the optimal cut-off point, demonstrating a sensitivity of 87% and specificity of 82%. Table 1. Comparison between groups according to their baseline clinical characteristics, disease activity, damage index, and treatments Table 2. Univariate aid multivariate analyses of serious infection in SLE GLADEL patients Conclusions Almost a third of patients had serious infections during the first year of follow-up. The score performed well in predicting serious infections, similar to the original score. References: [1.] Rua-Figueroa I. Lupus Sci Med 2024;11:e001096.

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