Friday, 20 Apr 2018

You are here

Stroke Risk Highest in the First Year of Lupus (Best of 2017)

Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

Using the Swedish National Patient Register (NPR, n=3390) with the general population comparators from the Total Population Register (n=16730), they identified SLE and non-SLE patients with CVA and followed prospectively until first of death.

They identified 126 strokes in SLE and 304 in the general population. SLE patients had a twofold increased rate of CVA (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). This finding was accentuated in females and individuals <50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5).

The risk of CVA in SLE was more than doubled compared to the general population.  The risk was highets within the first year after SLE diagnosis. The newly presenting SLE patients represents an opportunity to screen for risk factors for CVA.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Wear Your Pajamas to Work for Lupus

I suspect that everyone in rheumatology has a special place in their hearts for lupus patients. Their disease is so cruel, and we have so little to offer them, but the young women (and some men) that I treat keep battling on. The longer I have cared for them, the more I wanted to do for them. Managing their illness alone did not seem like enough. 

SynBioSe: Combo Rituximab and Belimumab Succeeds in Severe Refractory Lupus

One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs). 

Increased Comorbidity Burden in Lupus African Americans

Researchers from Vanderbilt University Medical Center used electronic health records (EHR) to perform a phenome-wide study comparing African American (AA-SLE) and Caucasian (C-SLE) with systemic lupus erythematosus (SLE) and found more comorbidities in AA-SLE, especially renal, cardiovascular, and infectious diseases.

The Consequences and Cure of Hepatitis C

I spent this past week seeing hepatitis C patients with our hepatologists, and being a rheumatologist, I was looking forward to seeing extra-hepatic manifestations of HCV that we read about in text-books - cryoglobulinemic vasculitis, sicca syndrome, porphyria cutanea tarda and many others. I suppose I should not be surprised that the week passed without seeing a single one of these. 

mTOR Inhibition with Sirolimus Effective in Lupus

Lancet reports that 12 months of sirolimus treatment is associated with improvement in lupus disease activity presumeably by correction of pro-inflammatory T-cell activity.