The objective was to determine the prevalence of the metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE) in Argentina, to assess the factors associated to it, and to compare the results with a control group with non-inflammatory disorders. The study included 147 patients with SLE and 119 controls. MS was defined according to criteria by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Scientific Statement. Demographic characteristics, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) were assessed as well as administration, maximum dose and cumulative dose of prednisone and hydroxychloroquine (HCQ). MS prevalence was 28.6% (CI 95%: 21.4-36.6) in patients with SLE and 16% in controls (P = 0.0019). Patients with SLE presented higher arterial hypertension frequency compared with controls (43 vs 25%, P = 0.007). When comparing lupus patients with MS (n = 41) and without MS (n = 106), no significant differences were observed regarding duration of the disease, SLEDAI or cumulative prednisone dose. Cumulative damage was associated independently with MS (OR 1.98; P = 0.021), whereas HCQ use was found to be protective (OR 0.13; P = 0.015). Patients with lupus presented higher MS prevalence than controls with non-inflammatory disorders, and occurrence of arterial hypertension was also higher. MS was associated with cumulative damage; the use of HCQ showed to be protective against presence of MS.

The aim of this study was to determine the factors associated with metabolic syndrome in patients with systemic lupus erythematosus from Puerto Rico. A total of 204 patients with systemic lupus erythematosus (per the American College of Rheumatology classification criteria) were evaluated. Metabolic syndrome was assessed using the American Heart Association and the National Heart, Lung, and Blood Institute classification. Socioeconomic-demographic parameters, health-related behaviours, clinical manifestations, autoantibodies, pharmacological treatments, disease activity (per the Systemic Lupus Activity Measure-Revised), and damage accrual (per the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) were determined at study visit. Factors associated with metabolic syndrome were examined by univariable analyses and multivariable logistic regression models. A total of 196 (96.2%) were women. The mean age at study visit was 43.6 ± 13.0 years, and the mean disease duration was 8.7 ± 7.7 years. Seventyeight patients (38.2%) had metabolic syndrome. In the multivariable analysis, age (odds ratio [OR] = 1.05; 95% confidence interval [CI] 1.02-1.09), government health insurance (OR = 2.06; 95% CI 1.07-4.22), exercise (OR = 0.33; 95% CI 0.14-0.92), thrombocytopenia (OR = 4.19; 95% CI 1.54-11.37), erythrocyte sedimentation rate (OR = 1.64; 95% CI 1.03-2.63), disease activity (OR = 1.14; 95% CI 1.00-1.30), and prednisone >10 mg/day (OR = 3.69; 95% CI 1.22-11.11) were associated with metabolic syndrome. In conclusion, older age, low socioeconomic status, lack of exercise, thrombocytopenia, increased erythrocyte sedimentation rate, higher disease activity, and prednisone >10 mg/day were independently associated with metabolic syndrome in patients with systemic lupus erythematosus from Puerto Rico.

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Objectives To evaluate the frequency of the different types of primary diseases of the respiratory system in a group of patients with Sistemic Lupus Erytematosus (SLE). Methods The target of the research were 243 patients with SLE who were assisted between 1980 and 2013 in a third level university hospital and they were registered in a specific data basis (Register AQUILES). There were chosen those patients with some kind of respiratory disease. Results 49 (20%) patients were identified. The most frequent manifestation was the pleurisy, present in 39 patients (16%). Other manifestations were the interstitial lung disease (ILD) present in 5 patients (2.1%), acute lupus pneumonitis (ALP) in 4 (1.6%), pulmonary hypertension in 7 (3%), respiratory muscular illness (shrinking lung syndrome) in 2 (0.8%) and pulmonary thromboembolism in 2 (0.8%). In the cases of ILD, the average time of evolution from SLE diagnosis was of 9.4±6.7 years. In the 5 patients, all of them were women, ILD evolved with dry cough and insidious dyspnea. 3 of these patients were controlled with glucocorticoids; the other two also required cyclophosphamide, achieving to stop the evolution of the disease in 1 case, whereas the other patient died. The ALP cases appeared within the first two years of the SLE evolution. The average age of the 4 women suffering from ALP was 38±12 years. In them, the symptoms appeared intensely with fever, pleuritic pain in 50% of the cases, cough with occasional haemoptoic expectoration, dyspnea, diffuse pulmonary infiltrates in the chest X-ray and active alveolitis in the CT. All of them were treated with prednisone at doses of 1 mg/kg/day and one of them was also given bolus of metylprednisolona. In two of the patients an immunosuppressing treatment was added. The evolution was favourable in all the cases. In the comparative research with 194 controls with SLE without respiratory involvement significant differences were observed, being the patients with lung affection those who presented the highest frequency of pericarditis (p=0.0001) and the highest score in the harm index of SLICC/ACR (p=0.001). Conclusions The pleural disease is the only primary disease of the respiratory system which is frequent in the SLE. The prevalence of the vascular lung disease, respiratory muscular disease, and of the different types of parenchymatous involvement is very low (≤3%). ALP is an early complication which usually takes place in the first years of the SLE evolution whereas ILD is a late complication. Both complications usually react to the treatment being the mortality rate low (11%). Neither the anti-Ro anti-bodies nor the anti-U1RNP seem to indentify the group of patients with the highest risk to develop these two complications. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5065