AB0453 ROLE OF COMBINATION AUTOANTIBODIES (ANTI-SMITH, Ro AND RNP ANTIBODIES) AND ETHNICITY IN ACCELERATED DEVELOPMENT OF LUPUS NEPHRITIS

Abstract

BackgroundLupus nephritis (LN) is an important concern among SLE patients in Asia and its mortality rate was reported to be 6 times higher compared to the general population [1]. A study by McCarty et al suggested that African women with serology showed combination of anti-Smith, Ro and RNP antibodies were at increased risk of developing LN [2]. This is further supported by study done by Majed et al showed this unusual combination accelerated development of LN within the first 5 years after SLE onset [3].ObjectivesTo determine the correlation between the combination of autoantibody profile: Smith, Ro and RNP in development of LN amongst Asian ancestry and any association with the duration of LN development from onset of SLE.MethodsThis was a retrospective study. The electronic medical records of all SLE patients seen in the rheumatology clinic Hospital Sultan Ismail, Malaysia from 1/1/2007 to 30/4/2021 were reviewed. Patients who had LN were identified and selected. Data on demography, serology, duration of development of LN from SLE onset were obtained and analysed using SPSS Pearson Chi square and binary logistic regression.ResultsThere were a total of 197 patients and 183 were females. The majority were Malays (96/197) followed by the non-Malay (101/197) which included Chinese (86/197) and others (15/197). The mean age group for the studied subjects was 34 (14-80).Of the 197 (100%) patients, 23 (11.7%) patients had the triple combination of Sm, Ro and RNP antibodies while 174 (88.3%) patients did not have the triple combination.For patient with the triple combination, regardless ethnicity, 20/23 (87%) developed LN within 5 years from the SLE onset while the remaining 3/23 (13%) developed LN after 5 years.For patients without this combination, regardless ethnicity, 142/174 (81.6%) of them developed LN within 5 years and 32/174 (18.4%) of them more than 5 years. This showed combination autoantibody does not significantly accelerated development of LN amongst Asian ancestry patients, P = 0.092.There was also no association between the positivity of triple antibody with the duration of development LN from SLE onset, P =0.772.Further stratification was based on ethnicity showed compare to Non-Malay ethnicity, the Malay patients is 3.966 higher odds of developing LN within the 5 years from SLE onset, P = 0.002.ConclusionPatient with triple serology combination did not showed significant in accelerating development of LN. Our data showed Malay patients are 4 higher odds of developing LN within the first 5 years after SLE onset compare to Non-Malay patients.References[1]Yap DY, Tang CS, Ma MK, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dial Transplant. 2012;27:3248–3254. [PubMed][2]McCarty GA, Harley JB, Reichlin M. A distinctive autoantibody profile in Black female patients with lupus nephritis. Arthritis & Rheumatism. 1993; 36:1560-1993[3]Majed R. Albirdisi, Shirish Sangle, Natasha Jordan, David D’Cruz. Autoantibody profile and ethnicity:risk factors for accelerated development of lupus nephritis. Abstract ACR 2020.Disclosure of InterestsNone declared