Statins in systemic lupus erythematosus

Abud-Mendoza, Carlos

doi:10.1136/annrheumdis-2017-212463

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…These effects were achieved selectively via reduction of membrane lipids, raising the possibility that targeting membrane lipids could control immune cell activation and may be a novel therapeutic target for autoimmunity. There is also some emerging evidence that targeting dyslipidaemia with statins in SLE is associated with decreased risk of flares [51]. Various studies have trialed the use of statins in SLE with mixed outcomes; some showing beneficial outcomes [52][53][54][55], and some not meeting their target such as the Lupus Atherosclerosis Prevention Study (LAPS) [56] in adults with SLE and the Atherosclerosis Prevention in Paediatric Lupus Erythematosus (APPLE) trial [57] in JSLE.…”

Section: Discussionmentioning

confidence: 99%

Metabolomics Defines Complex Patterns of Dyslipidaemia in Juvenile-SLE Patients Associated with Inflammation and Potential Cardiovascular Disease Risk

et al. 2021

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Cardiovascular disease (CVD) is a leading cause of mortality in patients with juvenile-onset systemic lupus erythematosus (JSLE) associated with atherosclerosis. The interplay between dyslipidaemia and inflammation—mechanisms that drive atherosclerosis—were investigated retrospectively in adolescent JSLE patients using lipoprotein-based serum metabolomics in patients with active and inactive disease, compared to healthy controls (HCs). Data was analysed using machine learning, logistic regression, and linear regression. Dyslipidaemia in JSLE patients was characterised by lower levels of small atheroprotective high-density lipoprotein subsets compared to HCs. These changes were exacerbated by active disease and additionally associated with significantly higher atherogenic very-low-density lipoproteins (VLDL) compared to patients with low disease activity. Atherogenic lipoprotein subset expression correlated positively with clinical and serological markers of JSLE disease activity/inflammation and was associated with disturbed liver function, and elevated expression of T-cell and B-cell lipid rafts (cell signalling platforms mediating immune cell activation). Finally, exposing VLDL/LDL from patients with active disease to HC lymphocytes induced a significant increase in lymphocyte lipid raft activation compared to VLDL/LDL from inactive patients. Thus, metabolomic analysis identified complex patterns of atherogenic dyslipidaemia in JSLE patients associated with inflammation. This could inform lipid-targeted therapies in JSLE to improve cardiovascular outcomes.

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Section: Discussionmentioning

confidence: 99%

Metabolomics Defines Complex Patterns of Dyslipidaemia in Juvenile-SLE Patients Associated with Inflammation and Potential Cardiovascular Disease Risk

et al. 2021

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“…10 Studies have compared the performance of SLICC criteria (sensitivity between 85% and 96.7%; specificity 76% and 83.6%) and ARC-EULAR (sensitivity between 87% and 96.3%; specificity 74% and 93.4%). [11][12][13] Both criteria performed worse in one of the studies, this, according to the authors, being due to a more selected population with several confounding factors. Thus, in more challenging situations, when classification criteria may be more useful, the performance can be sub-optimal.…”

Section: Introductionmentioning

confidence: 95%

<p>Towards Precision Medicine in Systemic Lupus Erythematosus</p>

Lever¹,

Alves²,

Isenberg³

2020

PGPM

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Systemic lupus erythematosus (SLE) is a remarkable condition characterised by diversity amongst its clinical features and immunological abnormalities. In this review, we attempt to capture the major immunological changes linked to the pathophysiology of lupus and discuss the challenge it presents in moving towards the concept of precision medicine. Currently broadly similar types of drugs, e.g., steroids, immunosuppressives, hydroxychloroquine are used to treat many of the diverse clinical features of SLE. We suspect that, as the precise immunopathological abnormalities differ between the various organs/systems in lupus patients, it will be some time before precision medicine can be fully applied to SLE.

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“…It was with great interest that we read the correspondence of Abud-Mendoza1 on our recent paper in which we described a decreased risk of developing systemic lupus erythematosus (SLE) in statin users who continued their therapy for >1 year 2…”

mentioning

confidence: 99%

“…Abud-Mendoza wondered whether inclusion of patients <40 years changed our findings 1. When we included these patients and excluded patients with SLE before the index date, we identified 539 431 statin users and 539 431 non-users after using a matched random sampling approach (1:1).…”

mentioning

confidence: 99%