197 A retrospective analysis on systemic lupus erythematosus in the indigenous and non-indigenous population in central australia focussing on treatment and outcomes of lupus nephritis

Aim To analyse and compare the prevalence, manifestations and outcomes of systemic lupus erythematosus (SLE) in the Indigenous and non-Indigenous population in Central Australia. Background SLE is a common autoimmune condition worldwide. With the development of better immunosuppression, outcome of the disease has significantly improved. There is a high prevalence of SLE in the Indigenous population in Central Australia. Methods The medical records of all patients diagnosed and/or being treated for SLE at Alice Springs Hospital from 1999 to March 2016 were reviewed. Only those with definite SLE, defined by the 2012 Systemic Lupus International Collaborating Clinics (SLICC) were included in this study. Results 39 patients fulfilled the criteria, 31 were Indigenous. 37 were female. The prevalence of SLE was 1:601 in the Indigenous and 1:4051 in the non-Indigenous. Both the groups fulfilled an average of 6 SLICC criteria. 18 patients 17 of whom were Indigenous, had biopsy proven lupus nephritis. The ISN-RPS 2003 lupus nephritis Class IV and V was most prevalent, followed by Class III. Various immunosuppressive regimes were used to treat lupus nephritis with varying responses. The Indigenous group had a high predisposition to infections, and the risk increased with immunosuppressive therapy. Non-adherence to treatment was a significant problem in the Indigenous group. 5 patients were deceased, 4 of whom were Indigenous. Conclusions There is a high prevalence of SLE in the Indigenous population in Central Australia. A low threshold for renal biopsy is recommended for classification and treatment purposes. Treatment regimes and response varied between individuals.