PT3:05 Spectrum of clinical and immunological features and patient-reported outcomes across type 1, type 2, mixed, and minimal SLE in a Swedish cohort

Objectives The Type 1&2 SLE model was developed to address discrepancy between physician- and patient-assessed SLE activity [Pisetsky 2019]. Here, we validate a recently described SF-36-based definition of Type 2 SLE in a large SLE cohort. We also investigate clinical and immunological features and patient-reported outcomes (PROMs) across Type 1, Type 2, Mixed, and Minimal SLE.Methods 376 SLE patients and 203 population controls completed the SF-36 survey in proximity to comprehensive clinical evaluation. 17 relevant raw items of SF-36 were selected, transformed, and summarized to yield the Type 2 SLE score [Arcani 2023]. Significant Type 1 SLE was defined as SLEDAI-2K > 6, or cSLEDAI > 4, and Type 2 SLE as Type 2 score > 14. Patients fulfilling both or no definitions were assigned as Mixed or Minimal SLE, respectively. Significance cutoff 14 was based on data distribution across two SLE cohorts and controls, and ROC analysis.Fatigue Severity Scale (FSS), EuroQol five-dimensional scale (EQ5D) pain domain, and Hospital Anxiety and Depression Scale (HADS) among the four SLE groups and controls were investigated. Clinical ACR-82 SLE criteria, APS, secondary Sjögren syndrome, and current positivity status for 11 autoantibodies were tabulated and studied among groups. Finally, the Type 1&2 groupings were investigated across four previously described autoantibody-defined SLE-subgroups (dominated by SSA/SSB, Sm/nucleosomes/dsDNA, aPL and absence of 13 investigated antibodies) [Diaz-Gallo 2022].Results Type 2 score was higher in SLE patients than controls (p