A COMPARATIVE STUDY ON CLINICAL AND SEROLOGICAL CHARACTERISTICS BETWEEN PATIENTS WITH RHUPUS AND PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Background: Concomitant presence of two autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is known as “Rhupus”. Although poliautoimmunity is not uncommon phenomenon, only a small series of patients have been described so far with Rhupus. Objectives: Our purpose was to analyze the clinical and serological characteristics of patients with Rhupus and compare them with a cohort of patients with SLE. Methods: In this cross-sectional study, we included cases of Rhupus (ACR/EULAR 2010 plus ACR 1987 criteria) from 11 different Rheumatology Departments at Catalonia, Spain. We included patients with a diagnosis of SLE in a 2:1 ratio matched by sex, race and disease duration. To avoid misclassification, those patients with Rhupus but who had Jaccoud’s arthropathy or with overlap syndromes were excluded. Results: A total of 120 patients were included, 40 cases with Rhupus and 80 cases with SLE. Most of patients were female (95%) and Caucasian (75%). Mean age was 51.0 ± 14.7 years with a mean disease duration of 12.9 ± 9.2 years. Main clinical characteristics were articular involvement (93.3%), cutaneous involvement (77.5%), haematological (72.5%), secondary Sjögren syndrome (38.7%) among others. Clinical and serological characteristics according different groups are shown in Table. Total N= 120 Rhupus n = 40 SLE n = 80 Gender (Female),% 114 (95%) 38 (95%) 76 (95%) 1 Mean age, years ± SD 51,0 ± 14,7 57,10 ± 14,1 47,9 ± 14,2 Disease duration, years ± SD 12,9 ± 9,2 13,6 ± 7,9 12,6 ± 9,8 Race (Caucasian),% 84 (75%) 25 (78,1%) 59 (73,8%) Clinical characteristics Cutaneous involvement,% 93 (77,5%) 31 (77,5%) 62 (77,5%) Articular involvement,% 112 (93,3%) 40 (100%) 72 (90,0%) · Arthritis,% 96 (80,0%) 40 (100%) 56 (70,0%) · Erosive disease,% 25 (20,8%) 24 (60,0%) 1 (1,3%) · Tenosynovitis,% 37 (30,8%) 22 (55,0%) 15 (18,8%) Renal involvement,% 24 (10%) 4 (10,0%) 20 (25,0%) Mean SLEDAI * 2,9 ± 2,8 2,6 ±2,5 3,0 ± 3,0 Immunological features Positive RF,% 37 (32,7%) 32 (80%) 6 (6,8%) Positive anti-CCP,% 33 (30,6%) 31(81,6%) 2 (2,9%) Comorbidity 44 (36,7%) 20 (50,0%) 24 (30,0%) SLICC * 0,8 ± 1,36 1,3 ± 1,55 0,6 ±1,2 Treatment (ever) Prednisolone,% 100 (84,7%) 39 (97,5%) 61 (78,2%) Antimalarial 109 (91,6%) 35 (89,7%) 74 (92,5%) MTX% 58 (48,7%) 33 (82,5%) 25 (31,6%) Rituximab,% 24 (20,2%) 13 (33,3%) 11 (13,8%) * Last visit, Comorbidities included: Hypertension, DM, dyslipemia, osteoporosis or Cushing. Conclusion: We found some clinical and serological differences among patients with Rhupus vs SLE alone. As expected, articular domains and positive RF and ACPAs were higher in Rhupus. By other hand, renal involvement was more common among “pure” SLE patients. Rhupus patients were more commonly treated with prednisolone, MTX and rituximab, and had more comorbidities and organ damage. If Rhupus represent a different condition, requires further analysis in bigger cohorts. Disclosure of Interests: Beatriz Frade Sosa: None declared, J. Narváez Consultant for: Bristol-Myers Squibb, Tarek Carlos Salman Monte: None declared, Vera Ortiz Santamaría: None declared, Vicenç Torrente Segarra : None declared, Ivan Castellví Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000 USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Berta Magallares: None declared, Raul Castellanos-Moreira Speakers bureau: MSD, Lilly, Delia Reina Speakers bureau: MSD, Novartis, Pfizer, Janssen, Sonia Mínguez: None declared, Maria Garcia Manrique de Lara: None declared, Sergi Ordoñez : None declared, Meritxell Sallés Lizarzaburu: None declared, Elena Riera Alonso: None declared, Jose A. Gómez-Puerta Consultant for: Pfizer, Roche, Speakers bureau: Abbvie, BMS, Janssen, MSD, Pfizer, Roche DOI: 10.1136/annrheumdis-2019-eular.7121Citation: Ann Rheum Dis, volume 78, supplement 2, year 2019, page A1719Session: SLE, Sjögren’s and APS - clinical aspects (other than treatment) (Scientific Abstracts)