AITD is frequent in SLE and does not affect the severity of SLE. Identified risk factors will assist clinicians in the search for AITD. Our results encourage smoke-free policies in patients with SLE.

ObjectivesTo examine the prevalence and associated factors related to the coexistence of antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) in a cohort of Colombian patients with SLE, and to discuss the coexistence of APS with other autoimmune diseases (ADs).MethodA total of 376 patients with SLE were assessed for the presence of the following: 1) confirmed APS; 2) positivity for antiphospholipid (aPL) antibodies without a prior thromboembolic nor obstetric event; and 3) SLE patients without APS nor positivity for aPL antibodies. Comparisons between groups 1 and 3 were evaluated by bivariate and multivariate analysis.ResultsAlthough the prevalence of aPL antibodies was 54%, APS was present in just 9.3% of SLE patients. In our series, besides cardiovascular disease (AOR 3.38, 95% CI 1.11–10.96, p = 0.035), pulmonary involvement (AOR 5.06, 95% CI 1.56–16.74, p = 0.007) and positivity for rheumatoid factor (AOR 4.68, 95%IC 1.63–14.98, p = 0.006) were factors significantly associated with APS-SLE. APS also may coexist with rheumatoid arthritis, Sjögren's syndrome, autoimmune thyroid diseases, systemic sclerosis, systemic vasculitis, dermatopolymyositis, primary biliary cirrhosis and autoimmune hepatitis.ConclusionsAPS is a systemic AD that may coexist with other ADs, the most common being SLE. Awareness of this polyautoimmunity should be addressed promptly to establish strategies for controlling modifiable risk factors in those patients.

Background Autoimmune thyroid disease (AITD) has been described as the most prevalent autoimmune disease (AD) as well as being associated with other organ-specific and non-organ specific ADs. Objectives To determine the prevalence, risk factors and the impact of AITD in patients with systemic lupus erythematosus (SLE). Methods A total of 376 patients with SLE were systematically assessed for the presence of: 1) confirmed AITD (i.e., TPOAb/TgAb and hypothyroidism), 2) positive TPOAb/TgAb without hypothyroidism, 3) clinical hypothyroidism without TPOAb/TgAb and 4) SLE patients with neither. Autoantibodies including TPOAb and TgAb were performed by ELISA. Comparisons between groups 1 and 4 were done by multivariate analysis and regression tree (CART) predictive model. Results The prevalence of confirmed AITD was 12%. The frequency of positive thyroid antibodies without hypothyroidism and clinical hypothyroidism without TPOAb/TgAb were 11% and 13.5%, respectively. SLE patients with neither were 40%. The duration of the disease was similar in groups 1 and 4. Patients with confirmed AITD were significantly older and had later age at onset of the disease. AITD was associated with multiple autoimmune syndrome (MAS), carrying Sjögren's Syndrome and with ever smoking, regardless of gender and duration of the disease (Table 1). These variables were also found as the main predictors for AITD in SLE. Table 1. Associated factors with AITD in SLE patients β AOR 95% CI AOR p Lower Upper SS 1,588 4,895 1,457 16,443 0,010 Ever Smoking 0,787 2,197 1,044 4,62 0,038 Female 2,172 8,777 0,665 115,884 0,099 AOR, Adjusted odds ratio; CI, Confidence interval; SS, Sjögren's syndrome. Conclusions Identified risk factors will assist clinicians in the search for AITD and encourage smoke-free policies in patients with SLE. AITD does not affect the severity of SLE. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4574

En años recientes han sido introducidos nuevos antianginosos al mercado con mecanismos de acción novedosos, complementarios a los del arsenal farmacoterapéutico existente. Aunque el tratamiento de primera línea continúan siendo los betabloqueadores, antagonistas de canales de calcio y nitratos, el descubrimientos de nuevos aspectos fisiopatológicos de la enfermedad permitieron el desarrollo de blancos terapéuticos innovadores a nivel celular y molecular. El nicorandil, la trimetazidina, la ivabradina y la ranolazina se consideran nuevos fármacos antianginosos y constituyen la segunda línea de tratamiento de la angina de pecho estable; están indicados en pacientes que persisten sintomáticos a pesar del manejo de primera línea o en aquellos que presentan intolerancia o contraindicación a los betabloqueadores o antagonistas de canales de calcio. La trimetazidina, a través de su mecanismo de acción metabólico, mejora la tolerancia al ejercicio y puede ser útil en pacientes con falla cardíaca y contraindicación al uso de digitales; la ivabradina tiene un efecto cronotrópico negativo sin afectar el inotropismo ni la tensión arterial por lo que se puede usar en pacientes con taquiarritmias o falla cardíaca concomitante; en contraste, la ranolazina no afecta el cronotropismo por lo que se usa en pacientes con bradiarritmias aunque puede generar prolongación del intervalo QTc. La elección de alguno de estos medicamentos antianginosos de primera o segunda línea debe ser individualizado para cada paciente y se basa en las comorbilidades, contraindicaciones y preferencias del paciente. MÉD.UIS. 2016;29(3):79-93.