title: Comprehensive description of clinical characteristics of a large systemic lupus erythematosus cohort from the Spanish Rheumatology Society Lupus Registry (RELESSER) with emphasis on complete versus incomplete lupus differences.
abstract: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple organ involvement and pronounced racial and ethnic heterogeneity. The aims of the present work were (1) to describe the cumulative clinical characteristics of those patients included in the Spanish Rheumatology Society SLE Registry (RELESSER), focusing on the differences between patients who fulfilled the 1997 ACR-SLE criteria versus those with less than 4 criteria (hereafter designated as incomplete SLE (iSLE)) and (2) to compare SLE patient characteristics with those documented in other multicentric SLE registries.RELESSER is a multicenter hospital-based registry, with a collection of data from a large, representative sample of adult patients with SLE (1997 ACR criteria) seen at Spanish rheumatology departments. The registry includes demographic data, comprehensive descriptions of clinical manifestations, as well as information about disease activity and severity, cumulative damage, comorbidities, treatments and mortality, using variables with highly standardized definitions.A total of 4.024 SLE patients (91% with ≥4 ACR criteria) were included. Ninety percent were women with a mean age at diagnosis of 35.4 years and a median duration of disease of 11.0 years. As expected, most SLE manifestations were more frequent in SLE patients than in iSLE ones and every one of the ACR criteria was also associated with SLE condition; this was particularly true of malar rash, oral ulcers and renal disorder. The analysis-adjusted by gender, age at diagnosis, and disease duration-revealed that higher disease activity, damage and SLE severity index are associated with SLE [OR: 1.14; 95% CI: 1.08-1.20 (P < 0.001); 1.29; 95% CI: 1.15-1.44 (P < 0.001); and 2.10; 95% CI: 1.83-2.42 (P < 0.001), respectively]. These results support the hypothesis that iSLE behaves as a relative stable and mild disease. SLE patients from the RELESSER register do not appear to differ substantially from other Caucasian populations and although activity [median SELENA-SLEDA: 2 (IQ: 0-4)], damage [median SLICC/ACR/DI: 1 (IQ: 0-2)], and severity [median KATZ index: 2 (IQ: 1-3)] scores were low, 1 of every 4 deaths was due to SLE activity.RELESSER represents the largest European SLE registry established to date, providing comprehensive, reliable and updated information on SLE in the southern European population.
authors.affiliation: From the Doctor Negrín University Hospital of Gran Canaria, Las Palmas GC, Las Plamas, Spain (ÍRF); Rheumatology Department Hospital Infanta Sofía, Madrid Spain (PR); Rheumatology Department Gregorio Marañón University Hospital, Madrid Spain (FJLL); Rheumatology Department Doce de Octubre University Hospital, Madrid Spain (MG); Rheumatology Department Sierrallana Hospital, Torrelavega Spain (JCA); Rheumatology Department Germans Trías i Pujol University Hospital, Badalona Spain (AOM); Research Unit Spanish Society of Rheumatology, Madrid Spain (ELS); Statistical Department Research Unit. Spanish Society of Rheumatology (SER); Madrid Spain (SPV); Rheumatology Department Dr Negrin General Hospital, Las Palmas de Gran Canaria, Spain (CE); Rheumatology Department La Princesa University Hospital, Madrid Spain (ET); Rheumatology Department Navarra Hospital Spain (LH); Rheumatology Department Donosti Hospital, Guipuzcoa Spain (EU); Rheumatology Department Príncipe de Asturias University Hospital, Madrid, Spain (ASA); Rheumatology Department H Marina Baixa, Alicante Spain (JR); Rheumatology Department Salamanca Clinic University Hospital Spain (CM); Rheumatology Department Carlos Haya University Hospital, Málaga, Spain (AFN); Rheumatology Department Hospital Complex of Ourense, Ourense Spain (MRG); Rheumatology Department Alicante General Hospital, Alicante, Spain (PV); Rheumatology Department Marqués de Valdecilla University Hospital, Santander Spain (RB); Rheumatology Department Juan Canalejo University Hospital, La Coruña Spain (MF); Rheumatology Department Guadalajara Hospital, Guadalajara Spain (LS); Rheumatology Department León Hospital, León Spain (EDÁ); Rheumatology Department Son Llatzer Hospital, Mallorca Spain (MIB); Rheumatology Department Ramon y Cajal, University Hospital, Madrid Spain (AZ); Rheumatology Department Bellvitge Hospital, Barcelona, Spain (JN); Rheumatology Department Marqués de Valdecilla University Hospital, Santander Spain (VMT); Rheumatology Department Valme Hospital, Sevilla Spain, (JLM); Rheumatology Department Puerta del Hierro-Majadahonda Hospital, Madrid Spain (MFC); Rheumatology Department Basurto Hospital, Basurto Spain (OFB); Rheumatology Department Hospital Insular of Gran Canaria, Gran Canaria Spain (JÁH); Rheumatology Department Tenerife Clinic Hospital, Tenerife Spain (MG); Rheumatology Department Virgen Macarena Hospital, Sevilla Spain (BHC); Rheumatology Department Jerez de la Frontera University Hospital, Cádiz Spain (JJPV); Rheumatology Department Miguel Servet University Hospital, Zaragoza Spain (ÁP); Rheumatology Department Virgen de la Arrixaca University Hospital, Murcia Spain (CM); Rheumatology Department Doce de Octubre University Hospital, Madrid Spain (PC); Rheumatology Department La Paz University Hospital, Madrid Spain (GB); MD, Rheumatology Department Hospitalet General Hospital, Hospitalet, Barcelona Spain (VT); Rheumatology Unit L'Alt Penedés District Hospital Spain (IC); Rheumatology Department Dr. Peset Hospital, Valencia Spain (JA); Rheumatology Department Parc Taulí Hospital, Barcelona Spain (MM); Rheumatology Department San Cecilio Hospital, Granada Spain (ER); Rheumatology Department Hospital Universitario Sanchinarro, Madrid Spain (PGP); Rheumatology Department Lucus Augusti, Kugo Spain (TV); Rheumatology Department Reina Sofía University Hospital, Cordoba Spain (ÁA); Rheumatology Unit Monforte Hospital, Lugo Spain (VQ); University Hospital Complex, Instituto de Investigación Biomédica de Vigo(IBIV) (Spain) Alto do Meixoeiro s/n, 36200 Vigo Spain (JMPR).
authors.forename: Íñigo
authors.initials: Í
authors.lastname: Rúa-Figueroa
authors.forename: Patricia
authors.initials: P
authors.lastname: Richi
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: López-Longo
authors.forename: María
authors.initials: M
authors.lastname: Galindo
authors.forename: Jaime
authors.initials: J
authors.lastname: Calvo-Alén
authors.forename: Alejandro
authors.initials: A
authors.lastname: Olivé-Marqués
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Loza-Santamaría
authors.forename: Sabina Pérez
authors.initials: SP
authors.lastname: Vicente
authors.forename: Celia
authors.initials: C
authors.lastname: Erausquin
authors.forename: Eva
authors.initials: E
authors.lastname: Tomero
authors.forename: Loreto
authors.initials: L
authors.lastname: Horcada
authors.forename: Esther
authors.initials: E
authors.lastname: Uriarte
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Atrio
authors.forename: José
authors.initials: J
authors.lastname: Rosas
authors.forename: Carlos
authors.initials: C
authors.lastname: Montilla
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Nebro
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Gómez
authors.forename: Paloma
authors.initials: P
authors.lastname: Vela
authors.forename: Ricardo
authors.initials: R
authors.lastname: Blanco
authors.forename: Mercedes
authors.initials: M
authors.lastname: Freire
authors.forename: Lucía
authors.initials: L
authors.lastname: Silva
authors.forename: Elvira
authors.initials: E
authors.lastname: Díez-Álvarez
authors.forename: Mónica
authors.initials: M
authors.lastname: Ibáñez-Barceló
authors.forename: Antonio
authors.initials: A
authors.lastname: Zea
authors.forename: Javier
authors.initials: J
authors.lastname: Narváez
authors.forename: Víctor
authors.initials: V
authors.lastname: Martínez-Taboada
authors.forename: José Luis
authors.initials: JL
authors.lastname: Marenco
authors.forename: Mónica Fernández
authors.initials: MF
authors.lastname: de Castro
authors.forename: Olaia
authors.initials: O
authors.lastname: Fernández-Berrizbeitia
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Hernández-Beriain
authors.forename: Marian
authors.initials: M
authors.lastname: Gantes
authors.forename: Blanca
authors.initials: B
authors.lastname: Hernández-Cruz
authors.forename: José J
authors.initials: JJ
authors.lastname: Pérez-Venegas
authors.forename: Ángela
authors.initials: Á
authors.lastname: Pecondón
authors.forename: Carlos
authors.initials: C
authors.lastname: Marras
authors.forename: Patricia
authors.initials: P
authors.lastname: Carreira
authors.forename: Gema
authors.initials: G
authors.lastname: Bonilla
authors.forename: Vicente
authors.initials: V
authors.lastname: Torrente
authors.forename: Iván
authors.initials: I
authors.lastname: Castellví
authors.forename: Juan
authors.initials: J
authors.lastname: Alegre
authors.forename: Mireia
authors.initials: M
authors.lastname: Moreno
authors.forename: Enrique
authors.initials: E
authors.lastname: Raya
authors.forename: Paloma García
authors.initials: PG
authors.lastname: de la Peña
authors.forename: Tomás
authors.initials: T
authors.lastname: Vázquez
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Aguirre
authors.forename: Víctor
authors.initials: V
authors.lastname: Quevedo
authors.forename: José M
authors.initials: JM
authors.lastname: Pego-Reigosa
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D012042:Registries; D013030:Spain / Q000453:epidemiology