FRI0423 Impact of Disease Activity on Organ Damage Risk Over Time in Systemic Lupus Erythematosus – The Hopkins Lupus Cohort

BackgroundDisease activity increases the risk of irreversible organ damage in systemic lupus erythematosus (SLE), but estimating that risk in absolute terms is challenging, given disease activity fluctuations, variable disease durations, and the roles of comorbid factors and treatment (corticosteroids) in organ damage.ObjectivesTo understand the impact of disease activity (measured by SELENA-SLEDAI score) and proportion of time with a certain level of disease activity (measured by the proportion of clinic visits with disease activity at or above a prespecified SELENA-SLEDAI score) on the risk of developing new irreversible organ damage, as measured by the SLICC/ACR Damage Index (SDI) score.MethodsCox proportional hazard models were used to estimate the impact of predictors, including measures of disease activity as time-dependent variables, on the risk of developing any new organ damage over time.ResultsPatients (N=2199) were followed for an average of 6.2 years (mean age at cohort entry, 38.0 years; mean disease duration, 5.1 years). The most frequent types of organ damage occurring over time were ocular (cataract) and musculoskeletal (osteoporotic fractures). In an initial model excluding the variable “proportion of clinic visits with SLEDAI score ≥6”, age and SDI score at cohort entry, SLEDAI score (