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Hydroxychloroquine plus low-dose aspirin protects against thrombosis in SLE

26 Jul 2017

The use of hydroxychloroquine (HCQ) and low-dose aspirin (ASA) appears to improve systemic lupus erythematosus (SLE), according to a recent study. This finding supports its continued use in patients with SLE.

Researchers enrolled patients who satisfied the 1997 American College of Rheumatology and/or 2012 Systemic Lupus Collaborating Clinics classification criteria for SLE, and had not experienced any cardiovascular (CV) event in this study, which aimed to assess the effects of HCQ cumulative dosages (c-HCQ) and the possible synergistic efficacy of ASA and HCQ in preventing a first CV event in such patients.

The occurrence of a thrombotic event, use of ASA and c-HCQ were recorded. Researchers performed Kaplan-Meier analysis to determine the c-HCQ associated with a lower incidence of CV events and Cox regression analysis to identify factors related to a first CV event.

A total of 189 patients with SLE were included in the study, with a median follow-up of 13 years. During follow-up, there were 10 CV events that occurred.

Kaplan-Meier analysis revealed that ASA-treated patients receiving a c-HCQ >600 g (standard HCQ dose for at least 5 years) had higher CV event-free rate than those receiving ASA alone, or with a c-HCQ dose <600 g (log-rank test chi-square, 4.01; p=0.04).

Based on multivariate analysis, antimalarials plus ASA were protective against thrombosis (hazard ratio [HR], 0.0431 and 0.047, respectively), while antiphospholipid antibodies (HR, 17.965) and hypertension (HR, 18.054) increased the risk of a first CV event.

“SLE is associated with an increased risk of cardiovascular disease,” researchers said. “Thromboprophylaxis with low-dose aspirin and hydroxychloroquine seems promising in SLE.”

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
20 hours ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 22 hours ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.