RESEARCH - Risk and protective factors for thrombosis in SLE

September 10, 2008

Ann Rheum Dis. Published Online First: 9 September 2008.

doi:10.1136/ard.2008.093013

Rheumatism

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Concise Report

Risk and protective factors for thrombosis in systemic lupus

erythematosus: results from a large, multi-ethnic cohort

Abstract

Objective: Few studies have examined thrombosis in SLE, none have

included Asian-Americans, and most have had small sample sizes. We

analyzed risk factors for thrombosis in a large, multi-ethnic SLE

cohort.

Methods: We studied 1930 SLE subjects including Caucasians,

African-Americans, Asian-Americans, and Hispanics. Data were derived

from questionnaires and medical records. Documented history of

thrombosis was the primary outcome. Explanatory variables included age

at SLE diagnosis, gender, ethnicity, disease duration, smoking,

antiphospholipid antibody (aPL) status, nephritis, and specific

medications.

Results: Smoking (OR 1.26, p=0.011), longer disease duration (OR 1.26

per 5 years p=0.027x10-7), nephritis (OR 1.35, p=0.036), aPL

positivity (OR 3.22, p <10-9) and immunomodulating medication use (OR

1.40, p=0.011) were statistically significant risk factors for

thrombosis. Younger age at SLE onset was protective (OR 0.52 for age

¡Ü 20, p=0.001). After adjusting for disease severity and

incorporating propensity scores, hydroxychloroquine use remained

significantly protective for thrombosis (OR 0.67, p=0.008).

Conclusions: This study confirms that older age at onset, longer

disease duration, smoking, aPL positivity, history of nephritis, and

immunomodulating medication use are risk factors for thrombosis in

SLE. These data are the first to confirm in a large and

ethnically-diverse SLE cohort that hydroxychloroquine use is

protective for thrombosis.

--

Not an MD

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