The goals of this study were to ascertain damage in patients with systemic lupus erythematosus (SLE) from five rheumatologic centres in Argentina and to examine overall damage, damage by domain and damage by item within each domain. We performed a retrospective observational study including patients with SLE (ACR 1997 revised and modified criteria) from five rheumatology centres in Argentina. Organ damage was scored using the SLICC/ACR DI (SDI), ascertained at years 1, 2, 5 and 10. Three centres provided information up to the fifth year. Of the 197 patients, 88.3% were women and their mean age was 33.2 years. The mean disease duration and follow-up were 7.6 and 5.3 years, respectively. Damage accrued gradually over time with SDI ranging from 0.52 (+/-1.1) at year 1 up to 2.46 (+/-2.1) at year 10. The renal system was the most involved system, followed by the neuropsychiatric, the cardiovascular and the musculoskeletal systems. Proteinuria, cognitive impairment, pericarditis, avascular necrosis, cataract and alopecia were the predominant items in their respective systems. Systems such as peripheral vascular, pulmonary, gastrointestinal, diabetes, malignancy and premature gonadal failure were not frequent. Overall SDI had a gradual increase over time. Damage in each domain of SDI, except for diabetes, had a similar behaviour. Behaviour of items in each domain varied.

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BackgroundBiobadasar is a registry that monitors adverse events in patients who use biological treatments in rheumatologic diseases conducted by the Argentine Society of Rheumatology. As in others international registries the community acquired pneumonia (CAP) has been detected as one of the most frequent infectological adverse events. Although all immunosuppressed patients should be vaccinated against streptococcus pneumoniae, there is a proportion of patients who are not.ObjectivesEvaluate the prevalence of pneumococcal vaccination in patients with CAP within the Biobadasar database. Assess factors associated with Severe CAP in these patients.MethodsA cross-sectional, multicentric study was made in BIOBADASAR database from 2010 to2016.In patients who reported CAP data of demographics, comorbidities and state of pneumococcal immunization was collected. Microbiological data, treatment and outcome of the event were considered. The severity of CAP was assessed according to the opinion of the attending physician, hospitalization, risk of life and/or death. Values are expressed as mean ± standard deviation, median (ranges) and frequencies (percentages), as appropriate. We performed bivariate and multivariate logistic regression analysis to identify variables associated with the event.ResultsOf the 4029 patients enrolled in the registry, the cumulative incidence of CAP was 4.2% (n 170), 72.4% (n 123) were women. The mean age was 57 (SD +/- 14.5). Biological treatment was found in 81.8% (n 139). Patient s that have received the pneumococcal vaccine were 40.6% (n=69). Severe CAP was detected in 7.1%. Streptococco Pneumoniae was the main pathogen isolated in 13% of the cases. Overall mortality was 4.1%. In the univariate analysis for severe CAP we found statistical significance for Smoking OR 3.88, CI95 1.063–14.22, p= 0.029 and chronic kidney disease (CKD) OR 31, CI95 2.6–376, p= 0.007. When performing a multiple logistic regression model, only renal failure OR 7.39 CI95 0.003–0.38 p= 0.007 was a predictor of severe CAP. Not significative association with immunosuppressive treatment (p: 0.09), age (p: 0.464), or vaccination (p: 0.937)ConclusionsThe annual incidence of CAP in Argentina varies between 0.5 -1.1% while in our cohort it was four times higher. The prevalence of pneumococcal vaccination was less than 50%, showing that, although the literature and guidelines establish the need for vaccination, this is not so in the real world. In the multivariate analysis, only CKD was related to severe CAP. Although in the univariate analysis the CKD and the smoking habit represented factors associated with severity. We must emphasize the medical education in following the international vaccination guidelines.Disclosure of InterestNone declared