Kravvariti E, et al. - Researchers assessed the effect of low disease activity and other disease-related factors on atherosclerosis progression in systemic lupus erythematosus (SLE) vs rheumatoid arthritis (RA). In SLE, plaque progression is faster, irrespective of disease activity. Findings suggested an association of this progression with antiphospholipid antibodies and the Systemic Coronary Risk Evaluation. Other factors in progression, in lupus low disease activity state (LLDAS), are cumulative corticosteroid dose and disease duration.

Methods

• Experts conducted a 3-year follow-up carotid and femoral artery ultrasound in 101 patients with SLE, 85 with RA, and 85 controls following a baseline examination in 115 SLE and 1:1 age- and gender-matched RA patients and controls.

· In order to compare atherosclerosis progression (new plaque development) between SLE and RA vs controls and to assess factors in progression of SLE patients with different lupus low disease activity state (LLDAS) durations, logistic regression was used; adjustments were made for disease-related factors, antihypertensives, antiplatelets, statins and the Systemic Coronary Risk Evaluation 10-year cardiovascular risk.

Results

• As per data, in SLE the odds ratio (OR) of plaque progression vs controls was significantly higher (OR = 2.81, P=0.043), but not in RA (OR = 2.22, P=0.109).
• Comparable results were seen in patients with low disease activity (88% of SLE, 74% of RA).
• In SLE, antiphospholipid antibodies (OR = 2.00, P=0.043) and Systemic Coronary Risk Evaluation (OR = 2.87, P=0.019) for all patients, and additionally cumulative corticosteroid dose during follow-up (OR = 1.38, P=0.013) and disease duration (OR = 1.20, P=0.022) for patients in LLDAS were included in multivariate determinants of progression included over entire follow-up.
• For patients with shorter LLDAS durations, comparable results were seen (>75% or >50% of follow-up).