OBJECTIVE: To determine the relationship between the presence of antiphospholipid (aPL) antibodies, hydroxychloroquine use and the occurrence of thrombotic events in patients with systemic lupus erythematosus (SLE). METHODS: Four hundred and forty-two SLE patients from the LUMINA (Lupus in Minorities: Nature vs Nurture) cohort, a multiethnic (Hispanics from Texas, n = 99 and Puerto Rico, n = 36; African Americans, n = 172; and Caucasians, n = 135) cohort, were studied by generalized estimating equation (GEE) to determine the relationship between antiphospholipid (aPL) antibodies (measured as IgG and IgM aPL antibodies and/or the lupus anticoagulant) at enrolment or historically prior to enrolment, hydroxychloroquine use (ever) and the occurrence of thrombotic (central and/or peripheral, arterial and/or venous) events after adjusting for known and possible confounders [socioeconomic-demographic features, smoking, disease activity and damage, serum cholesterol levels, anti-oxidized low-density lipoprotein IgG and IgM antibodies, and high-sensitivity (hs) C-reactive protein]. Postanalysis correlation between aPL and anticardiolipin (aCL) assays was attempted by performing aCL assays on random samples of patients whose aPL status was known. RESULTS: A number of clinical variables were significant in the univariable analyses; however, in the multivariable GEE analyses, only smoking [odds ratio (OR) 2.777, 95% confidence interval (CI) 1.317-5.852] and disease activity as measured by the SLAM (Systemic Lupus Activity Measure) (OR 1.099; 95% CI 1.053-1.147) were significant. In particular, hydroxychloroquine use, which appeared to be protective against thrombotic events in the univariable analyses, was not retained in the multivariable analyses. aPL antibodies were not significant in either analysis. Few additional aPL-positive patients emerged from the validation study. CONCLUSIONS: Smoking and disease activity emerged as important determinants in the occurrence of thrombotic events in our patients. Comprehensive treatment strategies should be directed to both smoking cessation and control of disease activity in patients with SLE.
OBJECTIVE: To determine the relationship between the presence of antiphospholipid (aPL) antibodies, hydroxychloroquine use and the occurrence of thrombotic events in patients with systemic lupus erythematosus (SLE). METHODS: Four hundred and forty-two SLEpatients from the LUMINA (Lupus in Minorities: Nature vs Nurture) cohort, a multiethnic (Hispanics from Texas, n = 99 and Puerto Rico, n = 36; African Americans, n = 172; and Caucasians, n = 135) cohort, were studied by generalized estimating equation (GEE) to determine the relationship between antiphospholipid (aPL) antibodies (measured as IgG and IgM aPL antibodies and/or the lupus anticoagulant) at enrolment or historically prior to enrolment, hydroxychloroquine use (ever) and the occurrence of thrombotic (central and/or peripheral, arterial and/or venous) events after adjusting for known and possible confounders [socioeconomic-demographic features, smoking, disease activity and damage, serum cholesterol levels, anti-oxidized low-density lipoprotein IgG and IgM antibodies, and high-sensitivity (hs) C-reactive protein]. Postanalysis correlation between aPL and anticardiolipin (aCL) assays was attempted by performing aCL assays on random samples of patients whose aPL status was known. RESULTS: A number of clinical variables were significant in the univariable analyses; however, in the multivariable GEE analyses, only smoking [odds ratio (OR) 2.777, 95% confidence interval (CI) 1.317-5.852] and disease activity as measured by the SLAM (Systemic Lupus Activity Measure) (OR 1.099; 95% CI 1.053-1.147) were significant. In particular, hydroxychloroquine use, which appeared to be protective against thrombotic events in the univariable analyses, was not retained in the multivariable analyses. aPL antibodies were not significant in either analysis. Few additional aPL-positive patients emerged from the validation study. CONCLUSIONS: Smoking and disease activity emerged as important determinants in the occurrence of thrombotic events in our patients. Comprehensive treatment strategies should be directed to both smoking cessation and control of disease activity in patients with SLE.
Authors: Entela Nuri; Mara Taraborelli; Laura Andreoli; Marta Tonello; Maria Gerosa; Antonia Calligaro; Lorenza Maria Argolini; Rajesh Kumar; Vittorio Pengo; Pier Luigi Meroni; Amelia Ruffatti; Angela Tincani Journal: Immunol Res Date: 2017-02 Impact factor: 2.829
Authors: Daniel J Wallace; Vineet S Gudsoorkar; Michael H Weisman; Swamy R Venuturupalli Journal: Nat Rev Rheumatol Date: 2012-07-17 Impact factor: 20.543
Authors: R Willis; A M Seif; G McGwin; L A Martinez-Martinez; E B González; N Dang; E Papalardo; J Liu; L M Vilá; J D Reveille; G S Alarcón; S S Pierangeli Journal: Lupus Date: 2012-02-17 Impact factor: 2.911
Authors: Rachel Kaiser; Yonghong Li; Monica Chang; Joseph Catanese; Ann B Begovich; Elizabeth E Brown; Jeffrey C Edberg; Gerald McGwin; Graciela S Alarcón; Rosalind Ramsey-Goldman; John D Reveille; Luis M Vilá; Michelle A Petri; Robert P Kimberly; Kimberly E Taylor; Lindsey A Criswell Journal: J Rheumatol Date: 2012-06-15 Impact factor: 4.666
Authors: Antonio Naranjo; Ana Bilbao; Celia Erausquin; Soledad Ojeda; Félix M Francisco; Iñigo Rúa-Figueroa; Carlos Rodríguez-Lozano Journal: Rheumatol Int Date: 2013-09-05 Impact factor: 2.631
Authors: Petrus Linge; Paul R Fortin; Christian Lood; Anders A Bengtsson; Eric Boilard Journal: Nat Rev Rheumatol Date: 2018-03-21 Impact factor: 20.543