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Nearly 30% of Patients With SLE Have Statin Prescription
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DESTIN, Fla. — Among patients with systemic lupus erythematosus, 16% also met the criteria for myocardial infarction and 28.8% had prescriptions for statins, according to findings presented at the 2018 National Young Rheumatology Investigator Forum.
“In patients with autoimmune conditions, statins have demonstrated clinical efficacy in modulating vascular risk factors, specifically limiting anti-inflammatory effects as measured by clinical and laboratory exam findings,” Yael Klionsky, MD, of Case Western Reserve-MetroHealth Medical Center, said during the presentation. “Data is inadequate in prior studies that have analyzed cardiovascular disease events such as myocardial infarction in patients with systemic lupus erythematosus (SLE) treated with statins.”
To determine patterns of statin use among patients with SLE, Klionsky and colleagues conducted a retrospective cohort study of the Explorys Inc. health database, which includes de-identified electronic records from 54 million patients across the United States. Using the database, the researchers identified patients with SLE via hydroxychloroquine use — excluding its use for malaria — with at least 1 antibody by the immunologic criteria set by the American College of Rheumatology.
The researchers compared the proportion of patients with SLE who experienced myocardial infarction — which they defined as a positive troponin greater than 0.1 — to those who did not, as well as the use of statin in both groups. In total, Klionsky and colleagues identified 41,330 patients with SLE in the database.
According to the researchers, among the patients with SLE identified in the database, 6,480, or 16%, also had criteria for myocardial infarction. In addition, 11,940 patients, or 28.8%, had prescriptions for statins, while the majority of patients (n=29,390) were not on statins. The two groups did not differ significantly in age, race or gender distribution, and both had similar SLE disease activity at 1, 3 and 5 years, Klionsky noted. Among the patients who were not using statins, 14% had myocardial infarctions. Of the patients who were on statin therapy, 19.7% had myocardial infarction, meaning that patients with prescriptions for statin were more likely to be associated with myocardial infarction (RR = 1.4; P < .001), the Klionsky said.
“This is the first retrospective analysis to evaluate patterns of statin use in patients with SLE using a large database like Explorys,” Klionsky said. “Our study uses a new method to define patients with SLE using large patient databases, revealing statin use is more prevalent in patient with SLE who are diagnosed with myocardial infarction. It remains unclear if statin were used for primary or secondary prevention in this subgroup.” – by Jason Laday
Reference:
Klionsky, Y. Statin therapy in SLE patients: Prevalence of statin use, using a large population database. Presented at: North American Young Rheumatology Investigator Forum; May 16, 2018; Destin, Fla.
Disclosure: Klionsky reports no relevant financial disclosures.