A.J Montiel Jarquín

Irritable bowel syndrome-type symptoms in female patients with mild systemic lupus erythematosus: frequency, related factors and quality of life.

Irritable bowel syndrome (IBS) impairs quality of life (HRQOL), as does systemic lupus erythematosus (SLE). Both are more common in women and are associated with fibromyalgia (FM). However, the relationship between IBS and SLE and its impact on HRQOL has not been explored. Therefore, we aimed to study the frequency and features likely to influence the presence of IBS‐type symptoms in SLE and their impact on HRQOL.

Bone mineral density in systemic lupus erythematosus women one year after rituximab therapy

The objective of this study was to assess the effects of rituximab on bone mineral density (BMD) in women with systemic lupus erythematosus (SLE) 1 year after treatment. Thirty active female SLE patients treated with rituximab were compared with 43 SLE women not treated with rituximab. BMD was measured using dual energy X-ray absorptiometry (DEXA) before initiating biologic therapy and after 1 year. The mean age was 38.5 ± 2.1 years; median disease duration was 7 years. In the rituximab group, after 1 year of follow-up, BMD at the femoral neck (FN) decreased from 0.980 ± 0.130 g/cm2 to 0.809 ± 0.139 g/cm2 (−17.4%; p = 0.001). Similarly, BMD at the lumbar spine (LS) decreased from 1.062 ± 0.137 g/cm2 to 0.893 ± 0.194 g/cm2 (−15.8%; p = 0.001). In control subjects, BMD at the FN decreased from 0.914 ± 0.193 g/cm2 to 0.890 ± 0.135 g/cm2 (−2.6%; p = 0.001), and BMD at the LS decreased from 0.926 ± 0.128 g/cm2 to 0.867 ± 0.139 g/cm2 (−6.2%; p = 0.09). After 1 year, SLE patients had lower BMD at both the FN and LS, but the loss was greater in postmenopausal patients who had received rituximab therapy.

Prevalence of functional gastrointestinal disorders in adults with systemic lupus erythematosus

Objective (a) to assess the prevalence of functional gastrointestinal disorders (FGIDs) in female Mexican systemic lupus erythematosus (SLE) patients using the Rome III criteria and (b) to examine the effect of disease duration on FGID prevalence. Methods Female SLE outpatients aged ≥18 years with no organic gastrointestinal disorder were included. Participants were invited to upper gastrointestinal endoscopy screening and a faecal immunochemical test. FGID symptoms were evaluated using the Rome III questionnaire. Results Eighty-six SLE patients with median age of 45 (interquartile range 34–54) years were included. At least one FGID was found in 76.7% (66/88) of patients with SLE. The most prevalent domains of FGID diagnosed were functional oesophageal, gastroduodenal disorders and bowel disorders, of which functional dyspepsia (72.7%), functional heartburn (68.1%) and bloating (63.8%) were the most frequent. Fifty-nine per cent of patients had overlapping FGIDs. The most prevalent overlap was the combination of functional dyspepsia and functional heartburn. Patients with longer disease duration had a higher prevalence of FGID than those with shorter disease duration. Conclusions There was a high prevalence of FGIDs in Mexican SLE women with low disease activity. Overlapping FGIDs were frequent. Longer disease duration may be associated with FGIDs in SLE patients.

AB0486 Incidence of vertebral fractures: 8 years follow-up study in women with systemic lupus erythematosus

Background Vertebral fractures (VF) are the hallmark of bone fragility. Patients with systemic lupus erythematosus (SLE) are at high risk of developing prevalent VF. Although several risk factors for VF in patients with SLE have been suggested, there is limited longitudinal supporting data in the literature. Objectives The aims of this study are to determine the incidence of VF and to evaluate possible associations between potential risk factors and the occurrence of VF in women with SLE. Methods Consecutive patients with SLE were enrolled in a prospective, observational study from 2006 to 2015. Information on potential risk factors, including demographics, clinical data and bone mineral density (BMD) at the lumbar spine and hip on dual-energy X-ray absorptiometry was collected at baseline and follow-up. Semi-quantitative analysis was used to determine incident VF on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20–25% reduction or more in any vertebral height) during follow-up. Differences in baseline characteristics were assessed in patients with and without radiographic VF. Statistical analysis: The Chi-square or Fishers exact test, independent samples t-test, and Mann-Whitney U-test were used as appropriate to compare baseline characteristics of patients with and without prevalent or incident VF. Possible risk factors for incident VF were assessed by multivariate logistic regression analysis. Results Of 110 SLE patients included, with a median follow-up of 8 (IQR 8–9) years, 22 (20%) had radiographic VF at baseline; 35 (32%) patients had a new VF. The annual incidence rate of new morphometric VF was 3.5 (95% CI 2.4–4.91) per 100 patient/years. Most fractures were located in the mid-thoracic and thoracolumbar region of the spine. Table 1 shows sociodemographic and clinical differences between patients with and without VF. In the multivariable analysis, VF were significantly associated with baseline BMD at the total hip and longer disease duration. Cumulative glucocorticoid dose, postmenopausal status and previous prevalent VF were not associated with VF. Conclusions In this SLE cohort in daily clinical practice, radiographic VF were frequently present in SLE patients, especially those with longer disease duration and low hip BMD. References Borba VZC, Matos PG, da Silva Viana PR, et al. High prevalence of vertebral deformity in premenopausal systemic lupus erythematosus patients. Lupus. 2005;14(7):529–33. Mendoza-Pinto C, García-Carrasco M, Sandoval-Cruz H, et al. Risk factors of vertebral fractures in women with systemic lupus erythematosus. Clin Rheumatol. 2009;28(5):579–85. Bultink IEM, Lems WF, Kostense PJ, et al. Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus. Arthritis Rheum. 2005;52(7):2044–50. Acknowledgements This work was supported in part by grant from FIS/IMSS/PROT/MD15/1500. Disclosure of Interest None declared