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Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). The cardioprotective benefits of aspirin (ASA) are well known and the ancillary CV and diabetogenic effects of hydroxychloroquine (HCQ) have also been shown. A current study in the Journal of Rheumatology has shown that thromboprophylaxis with low-dose ASA and HCQ) yields CVD benefits in SLE.
They enrolled 189 patients with SLE and monitored them for a median of 13 years and found 10 CVE occurred during followup. They found that a higher CVE-free rate ASA-treated patients administered a cumulative dose of HCQ > 600 grams, compared with patients receiving ASA alone, or with a cHCQ dose < 600 g (p = 0.04).
Multivariate analysis showed that antimalarials plus ASA protected against thrombosis (HR 0.041 and HR 0.047, respectively), while antiphospholipid antibodies (HR 17.965) and hypertension (HR 18.054) increased the risk of a first CVE.
These data suggest that prolonged use of HCQ plus ASA has a thromboprotective in SLE.