RESEARCH - Age at onset, APL status among risk factors for thrombosis in SLE

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Age at Onset, APL Status Among Risk Factors for Thrombosis in SLE

NEW YORK (Reuters Health) Feb 04 - The risk of thrombosis in patients

with systemic lupus erythematosus is increased by several factors,

including older age at onset, antiphospholipid antibody (aPL)

positivity, and history of nephritis, investigators report.

" Few studies have examined thrombosis in systemic lupus erythematosus

(SLE), none have included Asian-Americans, and most have had small

sample sizes, " Dr. Lindsey A. Criswell and colleagues from the

University of California, San Francisco, write in the February issue

of the ls of the Rheumatic Diseases.

The researchers used data from a large and ethnically diverse study

sample to examine risk factors for thrombosis in SLE. A total of 1930

patients from the UCSF Lupus Genetics Project were included in the

study, and 426 (22%) had at least one documented thrombosis, 119 (6%)

had at least two documented thromboses, and 516 (27%) were aPL

positive.

Significant risk factors for thrombosis were found to be smoking (odds

ratio 1.26), nephritis (OR 1.35), aPL positivity (OR 3.22), disease

duration (OR 1.26 per 5 years with SLE), and immunomodulating

medications (OR 1.40).

Younger age at SLE diagnosis protected against thrombosis (OR 0.52,

for age younger than 20 years at diagnosis).

" Treatment with hydroxychloroquine was protective for thrombosis when

adjusting for other explanatory variables (OR 0.67), " Dr. Criswell and

colleagues report.

Results of sensitivity analyses demonstrated that Asian-American and

African-American ethnicity, as well as female gender may be protective

against certain thrombosis subtypes.

" Importantly " the researchers conclude, their study " provides rigorous

evidence that patients with known risk factors for thrombosis, such as

aPL, might decrease their thrombosis risk by taking

hydroxychloroquine; however, this association needs to be tested in

prospective randomised controlled trials. "

Ann Rheum Dis 2009;68:238-241.

http://www.medscape.com/viewarticle/587842

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