Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Dermatology. https://doi.org/10.1001/jamadermatol.2024.4991 Dr. Henry W. Chen et al.
Points
- The research compared the risk of atherosclerotic cardiovascular disease (ASCVD) in patients with cutaneous lupus erythematosus (CLE) to individuals with systemic lupus erythematosus (SLE), psoriasis, and disease-free controls.
- CLE patients had a significantly higher ASCVD risk than disease-free controls (OR 1.72), a risk comparable to SLE (OR 2.41) but higher than psoriasis (OR 1.03).
- ASCVD incidence rates per 1,000 person-years were highest in SLE (24.8), followed by CLE (15.2), psoriasis (14.0), and controls (10.3). CLE patients showed an adjusted HR of 1.32 compared to controls.
- The study emphasizes the need for ASCVD screening in CLE patients, particularly those with severe disease or undergoing systemic treatments, to address elevated cardiovascular risks.
- CLE, though considered milder than SLE, carries a significant ASCVD risk, underscoring the importance of proactive cardiovascular risk management in this population.
Summary
This study aimed to investigate the risk of atherosclerotic cardiovascular disease (ASCVD) in patients with cutaneous lupus erythematosus (CLE) and compare it to individuals with systemic lupus erythematosus (SLE), psoriasis, and disease-free controls. A cohort of 8,138 individuals with CLE was matched to 24,675 individuals with SLE, 192,577 individuals with psoriasis, and 81,380 disease-free controls from the IBM MarketScan database. The analysis showed that individuals with CLE had a significantly higher risk of ASCVD compared to controls, with a multivariable-adjusted odds ratio (OR) of 1.72 (95% CI, 1.45-2.02; p < 0.001). This risk was comparable to individuals with SLE (OR, 2.41; 95% CI, 2.14-2.70; p < 0.001) but higher than individuals with psoriasis (OR, 1.03; 95% CI, 0.95-1.11; p = 0.48).
The study further found that, during a median follow-up of 3 years, the incidence rate of ASCVD per 1,000 person-years was highest in individuals with SLE (24.8, 95% CI, 23.3-26.4) followed by CLE (15.2, 95% CI, 13.1-17.7), psoriasis (14.0, 95% CI, 13.5-14.4), and controls (10.3, 95% CI, 9.77-10.94). The adjusted hazard ratio (HR) for incident ASCVD in CLE was 1.32 (95% CI, 1.13-1.55; p < 0.001), suggesting a significantly increased risk of ASCVD compared to controls, though the risk was lower than in those with SLE (HR, 2.23; 95% CI, 2.05-2.43; p < 0.001).
These findings underscore the increased risk of ASCVD in CLE, a condition often considered milder than SLE. The study highlights the importance of clinicians considering ASCVD screening in CLE patients, especially those with severe cases or receiving systemic treatment, to mitigate the cardiovascular risks associated with the condition.
Link to the article: https://jamanetwork.com/journals/jamadermatology/article-abstract/2826498
References Chen, H. W., Liu, J., Yang, D. M., Xie, Y., Peterson, E. D., Navar, A. M., & Chong, B. F. (2024). Incidence and prevalence of atherosclerotic cardiovascular disease in cutaneous lupus erythematosus. JAMA Dermatology. https://doi.org/10.1001/jamadermatol.2024.4991
