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Background Health Related Quality of Life (HRQoL) is important in systemic lupus erythematosus (SLE) for both global and organ specific disease. Objectives To examine the association between lupus nephritis at inception and patient self-report HRQoL in a large, multi-ethnic/racial, cohort of SLE patients. Methods An observational cohort study of new onset SLE (ACR classification criteria 60 ml/min); state 2 (eGFR: 30 – 60 mL/min); and state 3 (eGFR: 3.0 gr/day). HRQoL was determined by patient self-report SF-36 subscale scores, mental (MCS) and physical (PCS) component summary scores. Statistical analyses were based on analysis of variance or equivalent t-tests. Results There were 1,827 patients, 89% females, predominantly Caucasian (49.2%) with a mean ± SD age of 35.1±13.3 years. The mean ± SD disease duration was 0.5±0.3 years and the mean duration of follow-up was 4.6±3.4 years. The cumulative occurrence of lupus nephritis was 38.4% and the majority of patients (71.2%) were diagnosed at enrollment. SF-36 subscale and summary scores were not significantly lower in patients with lupus nephritis compared to those without nephritis at enrollment. However, for patients with lupus nephritis at enrollment or follow-up, those in state 3 GFR had clinically and statistically significant lower scores in three subscales (Physical function, Physical role and Bodily pain) and in the Physical component summary score of the SF-36 (p Conclusions The presence of lupus nephritis in a large multi-ethnic cohort was not associated with a reduction in HRQoL. However, severe impairment in renal function and to a lesser extent heavy proteinuria, were associated with lower subscale and physical component summary scores of the SF-36. Patient self-report HRQoL is reduced in severe lupus nephritis and may be an important outcome variable in clinical trials of renal disease in SLE. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.1114

Background The outcome of lupus nephritis has evolved over the past decade due to improved immunosuppressive therapies and close attention to co-morbidities. Objectives To study a large, prospective, multi-ethnic/racial, inception cohort of patients with systemic lupus erythematosus (SLE) to determine the outcome of lupus nephritis with current standard of care. Methods An international research network of 37 investigators in 32 academic centers from 11 countries participated in this study. Patients who fulfilled the American College of Rheumatology (ACR) classification criteria for SLE were evaluated within 15 months of diagnosis of SLE and annually thereafter, using a standardized protocol. Data collection included patient demographics, ACR classification criteria, medications, International Society of Nephrology (ISN) classification of chronic kidney disease (CKD) and of renal biopsies (when performed), estimated glomerular filtration rate (eGFR) and proteinuria (ePrU), end stage renal disease (ESRD), SLE disease activity index-2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics (SLICC)/ACR damage index (SDI). Chi-squared test and t-tests were used for group comparisons and Kaplan-Meier curves were produced for time to event analyses. Results There were 1,827 SLE patients, 89% females with a mean ±SD age of 35.1±13.3 years. The ethnic/racial distribution was 49.2% Caucasian, 16.6% African, 15.4% Hispanic, 14.9% Asian and 3.9% other. At enrollment, SLE duration was 0.5±0.3 years, SLEDAI-2K was 5.4±5.4, SDI was 0.31±0.74. The duration of follow-up was 4.6±3.4 years. Lupus nephritis, as defined in the ACR classification criteria, occurred in 499 (27.3%) patients at enrollment and in an additional 202 (11.1%) during follow-up for a cumulative prevalence of 38.4%. The frequency of nephritis was more common in Africans (46%), Hispanics (55%) and Asians (44%) compared to Caucasians (26%) (p Conclusions Lupus nephritis occurred in 38% of SLE patients in a large multi-ethnic/racial inception cohort. Nephritis presented most frequently around the time of diagnosis of SLE and was associated with individual patient9s racial/ethnic background. Although the outcome with standard of care was generally favourable, the results indicate the need for further therapeutic advances in the care of patients with lupus nephritis. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.1113