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Assessing and Treating CV Risk Increases in Systemic Lupus

Maureen A. McMahon, MD

We’ve recognized the increased risk of cardiovascular disease (CVD) in SLE for almost half a century since Urowitz et al. first described a bimodal pattern of mortality in lupus patients in 1976. Numerous subsequent studies have confirmed this, with estimates of increased risk ranging from 2-10-fold compared to the general population. Most striking is the risk in young patients; in their landmark study, Manzi et al. found that women with SLE in the 35–44-year age group had an almost 50-fold increased risk of myocardial infarction compared to age-matched women without SLE.

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Vitamin D Headlines (5.9.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy. 

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Emulation trials in SLE: Real or Fake?

Janet Pope, MD, MPH, FRCPC

Recently a landmark paper was published in A&R studying the results of an emulation trial on SGLT2i (sodium-glucose co-transporter 2 inhibitors) showing benefit in SLE patients with diabetes mellitus (DM), for both renal protection and reducing cardiovascular events, using data from an American large insurance claim database. My colleagues and I were able to write an editorial on this paper and describe emulation trials.

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More Women with Autoimmune Diseases Die from Cardiovascular Disease

EurekAlert!

Women with the autoimmune diseases rheumatoid arthritis, lupus or systemic sclerosis may have a higher rate of death related to cardiovascular disease than men with the autoimmune diseases, according to new research published in the American Heart Association’s journal Circulation: Cardiovascular Quality and Outcomes.

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Keys to Mastery (5.2.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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Is High Dose Aspirin Needed in Kawasaki Disease?

Jack Cush, MD

Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with Kawasaki disease (KD)?

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Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/Rf6c2gidpK
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Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/5V0yrctaFI

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Dr. John Cush RheumNow ( View Tweet)
Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/C0dpThYcMT
Dr. John Cush RheumNow ( View Tweet)
More Women with Autoimmune Diseases Die from Cardiovascular Disease Women with the autoimmune diseases rheumatoid arthritis, lupus or systemic sclerosis may have a higher rate of death related to cardiovascular disease than men with the autoimmune diseases, according to new https://t.co/Px9ayANsFL
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/z4zfDq9Wf9
Dr. John Cush RheumNow ( View Tweet)
Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/1PoPWPWNec

Links:

Dr. John Cush RheumNow ( View Tweet)
Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/JcTug1wsTZ
Dr. John Cush RheumNow ( View Tweet)
Secondary Benefits to SGLT2 Inhibitor Use in SLE An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus (SLE) patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 https://t.co/aQK4Sc9tdU
Dr. John Cush RheumNow ( View Tweet)
Study of 104 RA-ILD pts found that (31.7%) RA-ILD patients were ANCA positive (29/31 were p-ANCA+). compared to ANCA neg, ANCA+ RA-ILD had more respiratory Sxs, ANA positivity, worse PFTs, more acute exacerbations of ILD, more bronchietasis & honeycombing https://t.co/vZODUW9tSX https://t.co/zTrdtcc78O

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Dr. John Cush RheumNow ( View Tweet)
Study of 104 RA-ILD pts found that (31.7%) RA-ILD patients were ANCA positive (29/31 were p-ANCA+). compared to ANCA neg, ANCA+ RA-ILD had more respiratory Sxs, ANA positivity, worse PFTs, more acute exacerbations of ILD, more bronchietasis & honeycombing https://t.co/vZODUW9tSX https://t.co/6WUbSoOyOm

Links:

Dr. John Cush RheumNow ( View Tweet)
2001–2015 Danish national health registry study of 1.8 million adults, including 290,781 w/ knee or hip #OA & 1.5 million age-, sex-, education-matched controls. Women w/ knee or hip OA had 44% higher risk of CV Dz (HR 1.44), while men w/ HOA/KOA lesser incr (HR 1.24) CV risk https://t.co/C3ZHZiM38T
Dr. John Cush RheumNow ( View Tweet)
2001–2015 Danish national health registry study of 1.8 million adults, including 290,781 w/ knee or hip #OA & 1.5 million age-, sex-, education-matched controls. Women w/ knee or hip OA had 44% higher risk of CV Dz (HR 1.44), while men w/ HOA/KOA lesser incr (HR 1.24) CV risk https://t.co/P9V7m9rqAa
Dr. John Cush RheumNow ( View Tweet)
In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/Hnij8TWkYy https://t.co/wEuVcuAZ5j

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Dr. John Cush RheumNow ( View Tweet)
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