Longterm Hydroxychloroquine Therapy and Low-dose Aspirin May Have an Additive Effectiveness in the Primary Prevention of Cardiovascular Events in Patients with Systemic Lupus Erythematosus

The Journal of Rheumatology
Serena FasanoGabriele Valentini

Abstract

Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). Thromboprophylaxis with low-dose aspirin (ASA) and hydroxychloroquine (HCQ) seems promising in SLE. We investigated the effects of HCQ cumulative dosages (c-HCQ) and the possible synergistic efficacy of ASA and HCQ in preventing a first CV event (CVE) in patients with SLE. Patients consecutively admitted to our center who, at admission, satisfied the 1997 American College of Rheumatology and/or 2012 Systemic Lupus Collaborating Clinics classification criteria for SLE, and had not experienced any CVE, were enrolled. The occurrence of a thrombotic event, use of ASA, and c-HCQ were recorded. Kaplan-Meier analysis was performed to determine the c-HCQ associated with a lower incidence of CVE. Cox regression analysis served to identify factors associated with a first CVE. For the study, 189 patients with SLE were enrolled and monitored for 13 years (median). Ten CVE occurred during followup. At Kaplan-Meier analysis, the CVE-free rate was higher in ASA-treated patients administered a c-HCQ > 600 g (standard HCQ dose for at least 5 yrs) than in patients receiving ASA alone, or with a c-HCQ dose < 600 g (log-rank test chi-square = 4...Continue Reading

References

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Citations

Feb 22, 2018·Current Atherosclerosis Reports·Sagar DuganiSamia Mora
Jun 6, 2018·Current Opinion in Rheumatology·Yudong Liu, Mariana J Kaplan
Mar 31, 2019·Annals of the Rheumatic Diseases·Antonis FanouriakisDimitrios T Boumpas
Jun 3, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Clotilde ChatreYves-Marie Pers
Dec 11, 2019·The Journal of Experimental Medicine·Hung-Jen ChenMenno P J de Winther
Nov 1, 2018·Rheumatology·Giuseppe A RamirezHannah Cohen
Jan 25, 2020·Nature Reviews. Disease Primers·Hans-Joachim AndersChandra Mohan
Feb 9, 2020·Nature Reviews. Rheumatology·Eva Schrezenmeier, Thomas Dörner
Feb 13, 2018·Frontiers in Medicine·Vítor Teixeira, Lai-Shan Tam
Dec 28, 2019·Current Vascular Pharmacology·Myrto KostopoulouGeorge Bertsias
Dec 16, 2020·Journal of the American Academy of Dermatology·Jeanette Halskou HaugaardAlexander Egeberg
Nov 19, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Immacolata FaraoneLuigi Milella
Jan 31, 2021·Joint, Bone, Spine : Revue Du Rhumatisme·Alina DimaLaurent Arnaud

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