Hydroxychloroquine plus low-dose aspirin protects against thrombosis in SLE
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.”