Reduced carotid intima-media thickness in systemic lupus erythematosus patients treated with cyclosporine A

Kensuke Oryoji, Chikako Kiyohara, Takahiko Horiuchi, Hiroshi Tsukamoto, Hiroaki Niiro, Terufumi Shimoda, Koichi Akashi, Toshihiko Yanase

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Abstract

Background Patients with systemic lupus erythematosus (SLE) are at risk of atherosclerosis. An increased carotid intima-media thickness (IMT) is considered to be a marker of early atherosclerosis. Objective To determine influential factors for increased carotid IMT in SLE patients. Methods We evaluated the impact of conventional risk factors for atherosclerosis on carotid IMT in 427 healthy controls and of clinical factors on carotid IMT in 94 SLE patients. Carotid IMT was measured by using a newly developed computer-automated system. Unconditional logistic regression was used to assess the adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CI). Results Multivariate-adjusted mean carotid IMT (mm) was significantly reduced in SLE patients (0.51, 95 % CI = 0.36-0.66) compared to healthy controls (0.55, 95 % CI = 0.40-0.70) (P = 0.003). The SLE Disease Activity Index (SLEDAI) was associated with carotid IMT in a dose-dependent manner (Ptrend = 0.041). The current use of cyclosporine A (adjusted OR = 0.02, 95 % CI = 0.01-0.40, P = 0.011) and a history of steroid pulse therapy (adjusted OR = 0.01, 95 % CI = 0.01-0.25, P = 0.006) were significantly associated with a decreased risk of increased carotid IMT. Conclusions Our findings suggest that the current use of cyclosporine A can protect against increased carotid IMT, leading to a decreased risk of arteriosclerosis. Future studies with a larger sample size need to confirm that this association holds longitudinally.

Original languageEnglish
Pages (from-to)86-92
Number of pages7
JournalModern Rheumatology
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2014

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Carotid Intima-Media Thickness
Systemic Lupus Erythematosus
Cyclosporine
Confidence Intervals
Atherosclerosis
Odds Ratio
Arteriosclerosis
Computer Systems
Sample Size
Logistic Models
Steroids

All Science Journal Classification (ASJC) codes

  • Rheumatology

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Reduced carotid intima-media thickness in systemic lupus erythematosus patients treated with cyclosporine A. / Oryoji, Kensuke; Kiyohara, Chikako; Horiuchi, Takahiko; Tsukamoto, Hiroshi; Niiro, Hiroaki; Shimoda, Terufumi; Akashi, Koichi; Yanase, Toshihiko.

In: Modern Rheumatology, Vol. 24, No. 1, 01.01.2014, p. 86-92.

Research output: Contribution to journalArticle

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abstract = "Background Patients with systemic lupus erythematosus (SLE) are at risk of atherosclerosis. An increased carotid intima-media thickness (IMT) is considered to be a marker of early atherosclerosis. Objective To determine influential factors for increased carotid IMT in SLE patients. Methods We evaluated the impact of conventional risk factors for atherosclerosis on carotid IMT in 427 healthy controls and of clinical factors on carotid IMT in 94 SLE patients. Carotid IMT was measured by using a newly developed computer-automated system. Unconditional logistic regression was used to assess the adjusted odds ratios (ORs) and 95 {\%} confidence intervals (95 {\%} CI). Results Multivariate-adjusted mean carotid IMT (mm) was significantly reduced in SLE patients (0.51, 95 {\%} CI = 0.36-0.66) compared to healthy controls (0.55, 95 {\%} CI = 0.40-0.70) (P = 0.003). The SLE Disease Activity Index (SLEDAI) was associated with carotid IMT in a dose-dependent manner (Ptrend = 0.041). The current use of cyclosporine A (adjusted OR = 0.02, 95 {\%} CI = 0.01-0.40, P = 0.011) and a history of steroid pulse therapy (adjusted OR = 0.01, 95 {\%} CI = 0.01-0.25, P = 0.006) were significantly associated with a decreased risk of increased carotid IMT. Conclusions Our findings suggest that the current use of cyclosporine A can protect against increased carotid IMT, leading to a decreased risk of arteriosclerosis. Future studies with a larger sample size need to confirm that this association holds longitudinally.",
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