Older age increases risk of clot in lupus patients
( Wednesday 4th February 2009), source: www.reutershealth.com)
NEW YORK (Reuters Health) - Older age at diagnosis and kidney inflammation are among the factors that increase the risk of blood clots in patients with systemic lupus erythematosus, or SLE, new research shows.
SLE is a chronic "autoimmune" disease in which the immune system confuses its own healthy tissues with foreign tissues and sometimes attacks both. The disorder disproportionately affects women.
The condition can vary widely in severity, manifesting as skin rash and arthritis or leading to damage to the kidneys, heart, lungs and brain to varying degrees. It is marked sometimes by a characteristic butterfly-shaped rash on the face. There is no cure.
Blood clots in SLE patients have been the subject of few studies and no studies have included Asian-Americans. Most research has included only small numbers of patients, Dr. Lindsey A. Criswell and colleagues from the University of California, San Francisco, write in the Annals of the Rheumatic Diseases.
The researchers used data from a large and ethnically diverse study group to examine risk factors for blood clots, also known as thromboses, in SLE patients. A total of 1,930 patients from the UCSF Lupus Genetics Project were included in the study. Twenty-two percent had at least one documented thrombosis; 6 percent had at least two documented thromboses; and 27 percent tested positive for antiphospholipid antibody, an autoimmune antibody known to promote clotting.
Smoking, kidney inflammation, longer disease duration, a positive result for the antiphospholipid antibody, and the use of immune-altering drugs were all risk factors for blood clots.
By contrast, patients diagnosed with lupus at an early age were less likely to develop clots. Likewise, treatment with hydroxychloroquine, a commonly used anti-lupus drug, also reduced the risk of clots.
Lastly, there was also evidence that Asian-Americans and African-Americans had a reduced risk of some blood clots. The risk of clots was also lower in women than in men.
"Importantly," the researchers conclude, the study "provides rigorous evidence that patients with known risk factors for thrombosis, such as antiphospholipid antibody positivity, might decrease their thrombosis risk by taking hydroxychloroquine; however, this association needs to be tested."
SOURCE: Annals of the Rheumatic Diseases, February 2009.
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