AB0436 All The “Hispanics” Are Not Equal. The Severity and Activity of Patients with SLE Is Higher in Mestizos Latin American vs. European Caucasian. Lessons from Relesser: Table 1

Abstract

BackgroundSLE is a known disease for the study of ethnic and gender minorities. In Spain, from 1998 to 2011, occurred a significant immigration from Latin American people. The English speakers consider “Hispanics” as the same ethnic group. But there are differences between the Hispanics from Spain (with ethnicity European Caucasian) and the Hispanics from Latin America (with ethnicity Mestizo Latin American).ObjectivesTo know the demographic, clinical, severity, activity, damage, mortality and comorbidity of SLE in Hispanics with ethnicity European Caucasian (EC) and in Hispanic Mestizos from Latin American (MLA) residents in Spain. To identify differences between the groups.MethodsDesign: observational, multicentric, crossover study. Patients with SLE (ACR 1987) and <16 years old were included in 45 rheumatology Units in Spain. The RELESER methodology has been informed. Statistical analysis: we grouped the patients from the registry in two groups: EC and MLA and descriptive, univariate and multivariate statistics were done.Results3,490 patients with SLE were included, 90% females; 3,305 (92%) Hispanics EC y 185 (5%) Hispanics MLA. The Table shows the main variables. Patients MLA had higher levels of activity (SLEDAI), severity (KATZ INDEX) and number of admissions to the hospital for SLE activity. The damage index (SLICC), mortality, and comorbidity Index showed no differences. In the multivariate analysis several models were constructed with adjusted for age, sex and disease duration. The patients MLA had a higher risk for Severity (Katz Index >3) OR 1,45 (1,038 – 2, 026, p=0,02. This differences were not found for activity: OR 0,98 (0.30 - 1.66), may be for collinearity.Table 1VariableEuropean CaucasianMestizos Latin Americanpn, %n, %Total3.305, 92185, 5Women2.891, 90176, 950.02Myositis113, 315, 80.001Hemolytic anemia271, 824. 140.01Lupus nephritis952, 2979, 44<0.0001Serositis49, 19, 5<0.001Admissions related to LES activity1.741, 54120, 670.0001Median (IQR)Median (IQR)Age at SLE diagnosis (years)35.5 (24.3–44.5)30.5 (22.6–36.9)0.001Age at the study inclusion32.8 (22–42)28.6 (21–36)<0.001SLA disease duration (years) 1st symptom to diagnosis12.5 (5.7–17.5)7.9 (2.5–10.7)<0.0001Activity (SLEDAI)2.5 (0–4)3.8 (0–4)0.01Severity (KATZ)2.6 (1–3)2.9 (2–4)0.01Damage (SLICC)1.1 (0–2)0.9 (0–1)0.6Comorbidity (Charlson)2.3 (1–3)1.7 (1–2)0.2ConclusionsThe SLE of Hispanics MLA patients had clinical differences when it was compared with Hispanics EC patients, mainly higher severity and activity. This shows that all the Hispanics are not equal.Disclosure of InterestNone declared

Clustering of systemic lupus erythematosus mortality in southwestern Spain

“…31 In Spain, from 1998 to 2011, there was significant immigration of Latin Americans, and many of them settled in the south (in the provinces detected as a cluster of SLE) and the Mediterranean coastal area. 32…”

“…31 In Spain, from 1998 to 2011, there was significant immigration of Latin Americans, and many of them settled in the south (in the provinces detected as a cluster of SLE) and the Mediterranean coastal area. 32 In addition, the Romani population (the second most frequent ethnic group in Spain) has differences in the distribution of HLA alleles in relation to the white Caucasian Mediterranean population 33 (the main ethnic group) and in the clinical presentation of SLE (presents onset at earlier ages and higher frequency of thrombosis and antiphospholipid syndrome). 34,35 Approximately 15% of the Spanish Romani population resides in the four Andalusian provinces that make up the SLE mortality cluster.…”