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

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.