Cutaneous systemic lupus associated with increased risk for ASCVD, reveals research
Researchers have established that an association exists between cutaneous lupus erythematosus (CLE) and an increased risk for atherosclerotic cardiovascular disease (ASCVD), it is similar to that observed in patients with systemic lupus erythematosus (SLE), and is greater than among those with psoriasis. A recent study was conducted by Henry W. Chen and colleagues which was published in the journal of JAMA Dermatology.
This retrospective matched cohort study analyzed data from the IBM MarketScan Commercial Claims and Encounters Database from January 2018 through December 2020. A total of 8138 individuals with CLE were matched 10:1 with controls based on age, sex, insurance type, and enrollment duration; 24,675 had SLE and 192,577 had psoriasis.
Outcomes: ASCVD prevalence was determined by coronary artery disease, prior myocardial infarction, or cerebrovascular accident. Incident ASCVD was assessed via hospitalization events over a median follow-up of 3 years.
Statistical Analysis: Multivariable logistic regression and Cox proportional hazards models were used to adjust for age, sex, and cardiovascular risk factors.
The study yielded significant results regarding the ASCVD risk among individuals with CLE, SLE, and psoriasis:
Demographics:
• CLE: Mean age, 49 years; 81% female
• SLE: Mean age, 46 years; 91% female
• Psoriasis: Mean age, 48 years; 55% female
• Controls: Mean age, 49 years; 81% female
ASCVD Prevalence:
• ASCVD odds were higher in the CLE than controls at 1.72 [Odds Ratio (OR): 1.72; 95% CI, 1.45–2.02; p < 0.001].
• SLE showed the greatest odds for ASCVD, with OR = 2.41 (95% CI, 2.14–2.70; p < 0.001).
• Psoriasis did not have a significant increase in the odds of ASCVD (OR: 1.03; 95% CI, 0.95–1.11; p = 0.48).
ASCVD Incidence Rates per 1000 person-years:
• SLE: 24.8 (95% CI, 23.3–26.4).
• CLE: 15.2 (95% CI, 13.1–17.7).
• Psoriasis: 14.0 (95% CI, 13.5–14.4).
• Controls: 10.3 (95% CI, 9.77–10.94).
Hazard Ratios for Incident ASCVD
• SLE: 2.23 times greater risk than controls [Hazard Ratio (HR): 2.23; 95% CI, 2.05–2.43; p < 0.001].
• CLE: 1.32 times greater risk [HR: 1.32; 95% CI, 1.13–1.55; p < 0.001].
• Psoriasis: No significant risk increase [HR: 1.06; 95% CI, 0.99–1.13; p = 0.09].
This study found that patients with CLE had a significantly higher risk of developing ASCVD than that of SLE, though they were at a higher risk than those with psoriasis. Clinicians must consider this increased risk when managing CLE patients and take necessary measures for screening and prevention.
Reference:
Chen HW, Liu J, Yang DM, et al. Incidence and Prevalence of Atherosclerotic Cardiovascular Disease in Cutaneous Lupus Erythematosus. JAMA Dermatol. Published online December 04, 2024. doi:10.1001/jamadermatol.2024.4991
