The Effect of Statin Use on Mortality in Systemic Autoimmune Rheumatic Diseases

Objective.Systemic autoimmune rheumatic diseases (SARD) are associated with an increased risk of premature cardiovascular disease (CVD) and all-cause mortality. We examined the potential survival benefit of statin use among patients with SARD in a general population setting.Methods.We conducted an incident user cohort study using a UK general population database. Our population included patients with a SARD as determined by Read code diagnoses of systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, dermatomyositis, polymyositis, mixed connective tissue disease, Behçet disease, or antineutrophil cytoplasmic antibodies-associated vasculitis between January 1, 2000, and December 31, 2014. We compared propensity score–matched cohorts of statin initiators and noninitiators within 1-year cohort accrual blocks to account for potential confounders, including disease duration, body mass index, lifestyle factors, comorbidities, and medication use.Results.Of 2305 statin initiators, 298 died during the followup period (mean 5.1 yrs), whereas among 2305 propensity score–matched noninitiators, 338 died during the followup period (mean 4.8 yrs). This corresponded to mortality rates of 25.4/1000 and 30.3/1000 person-years, respectively. Statin initiation was associated with reduced all-cause mortality (HR 0.84, 95% CI 0.72–0.98). When we compared the unmatched cohorts, the statin initiators (n = 2863) showed increased mortality (HR 1.85, 95% CI 1.58–2.16) compared with noninitiators (n = 2863 randomly selected within 1-year cohort accrual blocks) because of confounding by indication.Conclusion.In this general population–based study, statin initiation was shown to reduce overall mortality in patients with SARD after adjusting for relevant determinates of CVD risk.

Download Full-text

Mortality in ANCA-associated vasculitis: ameta-analysis of observational studies

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-210942 ◽

2017 ◽

Vol 76 (9) ◽

pp. 1566-1574 ◽

Cited By ~ 42

Author(s):

Ju Ann Tan ◽

Natasha Dehghan ◽

Wenjia Chen ◽

Hui Xie ◽

John M Esdaile ◽

...

Keyword(s):

General Population ◽

Publication Bias ◽

Mortality Risk ◽

Observational Studies ◽

Consensus Conference ◽

Antineutrophil Cytoplasmic Antibodies ◽

Published Data ◽

Risk Of Death ◽

Increased Risk ◽

All Cause Mortality

ObjectiveTo determine the magnitude of all-cause mortality risk in patients with antineutrophil cytoplasmic antibodies-associated vasculitis (AAV) compared with the general population through a meta-analysis of observational studies.MethodsWe searched Medline and Embase databases from their inception to April 2015. Observational studies that met the following criteria were assessed by two researchers: (1) clearly defined AAV identified by either the American College of Rheumatology 1990 classification criteria or the 2012 Chapel Hill Consensus Conference disease definitions, and (2) reported standardised mortality ratios (SMR) and 95% CI. We calculated weighted-pooled summary estimates of SMRs (meta-SMRs) for all-cause mortality using random-effects model, tested for publication bias and heterogeneity.ResultsTen studies met the inclusion criteria, comprising 3338 patients with AAV enrolled from 1966 to 2009, and a total of 1091 observed deaths. Overall, we found a 2.7-fold increased risk of death in patients with AAV when compared with the general population (meta-SMR: 2.71 (95% CI 2.26 to 3.24)). Analysis on studies that included only granulomatosis with polyangiitis cases also indicated a similar mortality risk (meta-SMR: 2.63 (95% CI 2.02 to 3.43)). There was no significant publication bias or small-study effect. Subgroup analyses showed that mortality risks were higher in older cohorts, with a trend towards improvement over time (ie, those with their midpoint of enrolment periods that were between 1980–1993 and 1994–1999, vs 2000–2005).ConclusionPublished data indicate there is a 2.7-fold increase in mortality among patients with AAV compared with the general population.

Download Full-text

Factors Associated with Incident Severe Pulmonary Arterial Hypertension in Systemic Autoimmune Rheumatic Diseases: a Nationwide Study

Rheumatology ◽

10.1093/rheumatology/keab118 ◽

2021 ◽

Author(s):

Hsin-Hua Chen ◽

Ching-Heng Lin ◽

Tsu-Yi Hsieh ◽

Der-Yuan Chen ◽

Jia-Ching Ying ◽

...

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Conditional Logistic Regression ◽

Factors Associated ◽

Autoimmune Rheumatic Diseases ◽

Increased Risk ◽

Pulmonary Arterial ◽

Severe Pulmonary Arterial Hypertension

Abstract Objectives To assess the association of severe pulmonary arterial hypertension (PAH) with particulate matter <2.5 μm (PM2.5) and clinical data in patients with systemic autoimmune rheumatic diseases (SARDs). Methods We used the 2003–2017 nationwide data in Taiwan to identify patients with SARDs, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, dermatomyositis/polymyositis and primary Sjögren’s syndrome. We identified 479 cases with severe PAH and selected controls matched (1:4) for age, sex, and index-year. We used conditional logistic regression analysis to determine factors associated with risks for severe PAH shown as odds ratios (ORs) with 95% confidence intervals (CIs). Results We found that severe PAH was highly associated with interstitial lung disease (OR, 8.57; 95% CI, 5.52–13.32), congestive heart failure (OR, 7.62; 95% CI, 5.02–11.55), valvular heart disease (OR, 3.34; 95% CI, 2.03–5.50) and slightly associated with thyroid diseases (OR, 1.88; 95% CI, 1.18–3.00), but not the level of exposure to PM2.5. Increased risk for PAH was found in patients receiving corticosteroid (prednisolone equivalent dosage, mg/day, OR, 1.03; 95% CI, 1.01–1.05), biologics (OR, 2.18; 95% CI, 1.15–4.12) as well as immunosuppressants, including cyclosporin (OR, 2.17; 95% CI, 1.31–3.59), azathioprine (OR, 1.96; 95% CI, 1.48–2.61), cyclophosphamide (OR, 2.01; 95% CI, 1.30–3.11) and mycophenolate mofetil/mycophenolic acid (OR, 2.42; 95% CI, 1.37–4.27), and those with the highest level of insured amount (reference, lowest level; OR, 0.53; 95% CI, 0.34–0.83). Conclusion The population-based study identified risks for severe PAH in patients with SARDs, and these findings provide evidence for PAH risk stratification in patients with SARDs.

Download Full-text

Cardiovascular Consequences of Autoimmune Rheumatic Diseases

Current Vascular Pharmacology ◽

10.2174/1570161118666200127142936 ◽

2020 ◽

Vol 18 (6) ◽

pp. 566-579 ◽

Cited By ~ 1

Author(s):

Fabiola Atzeni ◽

Valeria Nucera ◽

Elisabetta Gerratana ◽

Alessia Fiorenza ◽

Luigi Gianturco ◽

...

Keyword(s):

Risk Factors ◽

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Imaging Techniques ◽

Endothelial Activation ◽

Low Grade ◽

Autoimmune Rheumatic Diseases ◽

The Metabolic Syndrome ◽

Increased Risk ◽

The Individual

: The increased risk of cardiovascular disease (CVD) among patients with autoimmune rheumatic diseases such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus has been extensively documented. Sub-clinical atherosclerosis can be assessed using various non-invasive imaging techniques. However, the mechanisms underlying the higher risk of atherosclerotic CVD in patients with autoimmune rheumatic diseases are not fully known, although they seem to include chronic low-grade systemic inflammation leading to prolonged endothelial activation, accompanied by a pro-thrombotic/pro-coagulant and autoantibody state. Furthermore, sub-clinical atherosclerosis is also influenced by other traditional risk factors for CVD. Including the individual components of the metabolic syndrome (MetS: obesity, impaired glucose metabolism, dyslipidemia and high blood pressure), the degree of which is higher in these patients than in controls. The aim of this narrative review is to discuss the CV manifestations and risk factors involved in the increased risk of CVD among patients with autoimmune rheumatic diseases.

Download Full-text

Risk of severe coronavirus infection (COVID-19) in patients with inflammatory rheumatic diseases.

The Journal of Rheumatology ◽

10.3899/jrheum.200755 ◽

2021 ◽

pp. jrheum.200755

Author(s):

Javier Bachiller-Corral ◽

Alina Boteanu ◽

Maria Jesus Garcia-Villanueva ◽

Carlos de la Puente ◽

Marcelino Revenga ◽

...

Keyword(s):

General Population ◽

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Severe Pneumonia ◽

Inflammatory Rheumatic Diseases ◽

Jak Inhibitors ◽

Increased Risk ◽

Conventional Dmards ◽

Coronavirus Infection ◽

Single Center Observational Study

Objective To describe the cohort of patients with inflammatory rheumatic diseases (IRD) hospitalized due to SARS-CoV-2 infection in our hospital and to determine the increased risk of severe coronavirus disease regarding no IRD patients. Methods Retrospective single-center observational study of patients with IRD actively monitored in the Department of Rheumatology who were hospitalized due to COVID- 19. Results 41 (1,8%) out of 2,315 patients admitted due to severe SARS-CoV-2 pneumonia suffered from an IRD. The admission Odds ratio (OR) for IRD patients was 1.87 against the general population, and it was higher in patients with Sjögren’s syndrome, vasculitis and systemic lupus erythematosus. Twenty-seven patients were receiving treatment for IRD with corticosteroids, 23 with conventional DMARDs, 12 with biologics (7 rituximab, 4 anti-TNF and 1 abatacept) and 1 with JAK inhibitors. Ten deaths were registered among patients with IRD. A higher hospitalization rate and a higher number of deaths were observed in patients treated with rituximab (OR=12.8) but not in patients treated with anti-TNF (OR=0.9). Conclusion Patients with IRD, especially autoimmune diseases and patients treated with rituximab, may be at higher risk of severe pneumonia due to SARS-Cov 2, compared to the general population. More studies are needed to analyze this association further in order to help managing these patients during the pandemic.

Download Full-text

Risk of malignancy in patients with rheumatic disorders

Hong Kong Bulletin on Rheumatic Diseases ◽

10.1515/hkbrd-2016-0008 ◽

2016 ◽

Vol 16 (2) ◽

pp. 38-41

Author(s):

Victor Tak-lung Wong ◽

Weng-nga Lao

Keyword(s):

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Disease Burden ◽

Immunosuppressive Agents ◽

Biologic Therapies ◽

Inflammatory Myositis ◽

Autoimmune Rheumatic Diseases ◽

Increased Risk ◽

Risk Of Malignancy

Abstract Patients with autoimmune rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren’s syndrome (SS), and inflammatory myositis are at increased risk of developing malignancies. Treatment of these conditions, including disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies, are also associated with increased risk of malignancies.Cancer adds to the disease burden in these patients, affecting their quality of life and life expectancy. The decision in choosing immunosuppressive agents in these rheumatic diseases should take into account the disease severity, expectation for disease control, comorbidities, as well asthe side effects including risks of cancer. This article does not include the risk of malignancy in patients with the idiopathic inflammatory myopathies, which are well-recognized paraneoplastic conditions.

Download Full-text

AB0430 MORTALITY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND NEUROPSYCHIATRIC SYMPTOMS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.939 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1514.2-1514

Author(s):

R. Monahan ◽

R. Fronczek ◽

J. Eikenboom ◽

H. Middelkoop ◽

L. J. J. Beaart- van de Voorde ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

General Population ◽

Clinical Diagnosis ◽

Lupus Erythematosus ◽

Neuropsychiatric Symptoms ◽

Current Status ◽

Systemic Lupus ◽

Risk Of Death ◽

Increased Risk ◽

All Cause Mortality

Background:Little is known about mortality in patients with systemic lupus erythematosus (SLE) presenting with neuropsychiatric (NP) symptoms.Objectives:We aimed to evaluate all-cause and cause-specific mortality in patients with SLE and NP symptoms.Methods:All patients with the clinical diagnosis of SLE of 18 years and older that visited the tertiary referral NPSLE clinic of the Leiden University Medical Center between 2007-2018 and signed informed consent were included in this study. Patients were classified as NPSLE if NP symptoms were attributed to SLE and immunosuppressive or anticoagulant therapy was initiated, otherwise patients were classified as non-NPSLE. Municipal registries were checked for current status (alive/deceased). Electronical medical files were studied for clinical characteristics and cause of death. Standardized mortality ratios (SMRs) and 95% confidence intervals were calculated using data from the general Dutch population. In addition, a rate ratio (RR) was calculated using direct standardization to compare mortality in NPSLE with non-NPSLE patients.Results:351 patients with the clinical diagnosis of SLE were included, of which 149 patients were classified as NPSLE (42.5%). Compared with the general population, mortality was increased five times in NPSLE (SMR 5.0, 95% CI: 2.6-8.5) and nearly four times in non-NPSLE patients (SMR 3.7, 95% CI: 2.2-6.0), as shown in Table 1. Risk of death due to cardiovascular disease (CVD) was increased in non-NPSLE patients (SMR 6.2, 95% CI: 2.0-14.6) and an increased risk of death to infections was present in both NPSLE and non-NPSLE patients ((SMR 29.9, 95% CI: 3.5 – 105) and SMR 91.3 (95% CI: 18.8 – 266) respectively). However, mortality did not differ between NPSLE and non-NPSLE patients (RR 1.0, 95% CI: 0.5 – 2.0).Table 1.All-cause mortality in SLE patients presenting with neuropsychiatric symptoms attributed to SLE (NPSLE) or to other causes (non-NPSLE)NPSLE(N = 149)Non-NPSLE(N = 202)Deaths (N, %)13 (8.7)17 (8.4)Age at death (median, range)49 (32 – 79)59 (20 – 89)Follow-up time (years)9061047Crude mortality rate (per 1000 PY)14.316.2All-cause mortality*Female5.5 (2.8 – 9.6)3.4 (1.9 – 5.7)Male2.3 (0.1 - 12.8)6.2 (1.3 – 18.2)Combined5.0 (2.6 – 8.5)3.7 (2.2 – 6.0)*Standardized mortality ratio, ratio of the observed and expected number of deathsConclusion:Mortality was increased in both NPSLE and non-NPSLE patients in comparison with the general population, but there was no difference in mortality between NPSLE and non-NPSLE patients. Risk of death due to infections was increased in both groups.Disclosure of Interests:Rory Monahan: None declared, Rolf Fronczek: None declared, Jeroen Eikenboom: None declared, Huub Middelkoop: None declared, L.J.J. Beaart- van de Voorde: None declared, Gisela Terwindt: None declared, Nic van der Wee: None declared, Frits Rosendaal: None declared, Thomas Huizinga Grant/research support from: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Consultant of: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Margreet Kloppenburg: None declared, G.M. Steup-Beekman: None declared

Download Full-text

Phase 1 double-blind randomized safety trial of the Janus kinase inhibitor tofacitinib in systemic lupus erythematosus

Nature Communications ◽

10.1038/s41467-021-23361-z ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Sarfaraz A. Hasni ◽

Sarthak Gupta ◽

Michael Davis ◽

Elaine Poncio ◽

Yenealem Temesgen-Oyelakin ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Kinase Inhibitor ◽

Janus Kinase ◽

Controlled Clinical Trial ◽

Type I ◽

Systemic Lupus ◽

Double Blind ◽

Premature Cardiovascular Disease ◽

Increased Risk

AbstractIncreased risk of premature cardiovascular disease (CVD) is well recognized in systemic lupus erythematosus (SLE). Aberrant type I-Interferon (IFN)-neutrophil interactions contribute to this enhanced CVD risk. In lupus animal models, the Janus kinase (JAK) inhibitor tofacitinib improves clinical features, immune dysregulation and vascular dysfunction. We conducted a randomized, double-blind, placebo-controlled clinical trial of tofacitinib in SLE subjects (ClinicalTrials.gov NCT02535689). In this study, 30 subjects are randomized to tofacitinib (5 mg twice daily) or placebo in 2:1 block. The primary outcome of this study is safety and tolerability of tofacitinib. The secondary outcomes include clinical response and mechanistic studies. The tofacitinib is found to be safe in SLE meeting study’s primary endpoint. We also show that tofacitinib improves cardiometabolic and immunologic parameters associated with the premature atherosclerosis in SLE. Tofacitinib improves high-density lipoprotein cholesterol levels (p = 0.0006, CI 95%: 4.12, 13.32) and particle number (p = 0.0008, CI 95%: 1.58, 5.33); lecithin: cholesterol acyltransferase concentration (p = 0.024, CI 95%: 1.1, −26.5), cholesterol efflux capacity (p = 0.08, CI 95%: −0.01, 0.24), improvements in arterial stiffness and endothelium-dependent vasorelaxation and decrease in type I IFN gene signature, low-density granulocytes and circulating NETs. Some of these improvements are more robust in subjects with STAT4 risk allele.

Download Full-text

Association of Particulate Matter with Autoimmune Rheumatic Diseases among Adults in South Korea

Rheumatology ◽

10.1093/rheumatology/keab127 ◽

2021 ◽

Author(s):

Jun Seok Park ◽

Seulggie Choi ◽

Kyuwoong Kim ◽

Jooyoung Chang ◽

Sung Min Kim ◽

...

Keyword(s):

Particulate Matter ◽

Adverse Effects ◽

South Korea ◽

Rheumatic Diseases ◽

Lupus Erythematosus ◽

Cox Regression ◽

Statistical Significance ◽

Cox Regression Analysis ◽

Autoimmune Rheumatic Diseases ◽

Quartile Group

Abstract Objective The primary objective is to investigate adverse effects of ambient particulate matter (PM) in various size on the incidence of prevalent autoimmune rheumatic diseases (AIRDs): Rheumatoid Arthritis (RA), Ankylosing Spondylitis (AS), and Systemic Lupus Erythematosus (SLE). Methods We investigated 230,034 participants in three metropolitan cities of South Korea from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Starting from January 2010, subjects were followed up until the first event of prevalent AIRDs, death, or December 2013. 2008-2009 respective averages of PM2.5 (< 2.5μm) and PMcoarse (2.5μm to 10μm) were linked with participants’ administrative district codes. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using Cox regression analysis in one- and two-pollutant model. Results Adjusted for age, sex, region, and household income in two-pollutant model, RA incidence was positively associated with 10μg/m³ increment of PM2.5 (aHR = 1.74, 95% CI: 1.06-2.86), but not with PMcoarse (aHR = 1.27, 95% CI: 0.87-1.85). In one-pollutant model, an elevated incidence rate of RA was slightly attenuated (PM2.5 aHR = 1.61, 95% CI: 0.99-2.61; PMcoarse aHR = 1.13, 95% CI: 0.80-1.61), with marginal statistical significance of PM2.5. RA incidence was also higher in 4th quartile group of PM2.5 compared to 1st quartile group (aHR = 1.83, 95% CI: 1.07-3.11). No adverse effects of PM were found on AS or SLE in one- and two-pollutant models. Conclusion Important components of PM10 associated with RA incidence were fine fractions (PM2.5), while no positive association was found between PM and AS or SLE.

Download Full-text

The association of hepatic steatosis and fibrosis with heart failure and mortality

Cardiovascular Diabetology ◽

10.1186/s12933-021-01374-8 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Jiyun Park ◽

Gyuri Kim ◽

Hasung Kim ◽

Jungkuk Lee ◽

You-Bin Lee ◽

...

Keyword(s):

Heart Failure ◽

General Population ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Patient Group ◽

Cox Regression ◽

Nonalcoholic Fatty Liver ◽

Fatty Liver Index ◽

Increased Risk ◽

All Cause Mortality

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic disease and independently affects the development of cardiovascular (CV) disease. We investigated whether hepatic steatosis and/or fibrosis are associated with the development of incident heart failure (iHF), hospitalized HF (hHF), mortality, and CV death in both the general population and HF patients. Methods We analyzed 778,739 individuals without HF and 7445 patients with pre-existing HF aged 40 to 80 years who underwent a national health check-up from January 2009 to December 2012. The presence of hepatic steatosis and advanced hepatic fibrosis was determined using cutoff values for fatty liver index (FLI) and BARD score. We evaluated the association of FLI or BARD score with the development of iHF, hHF, mortality and CV death using multivariable-adjusted Cox regression models. Results A total of 28,524 (3.7%) individuals in the general population and 1422 (19.1%) pre-existing HF patients developed iHF and hHF respectively. In the multivariable-adjusted model, participants with an FLI ≥ 60 were at increased risk for iHF (hazard ratio [HR], 95% confidence interval [CI], 1.30, 1.24–1.36), hHF (HR 1.54, 95% CI 1.44–1.66), all-cause mortality (HR 1.62, 95% CI 1.54–1.70), and CV mortality (HR 1.41 95% CI 1.22–1.63) in the general population and hHF (HR 1.26, 95% CI 1.21–1.54) and all-cause mortality (HR 1.54 95% CI 1.24–1.92) in the HF patient group compared with an FLI < 20. Among participants with NAFLD, advanced liver fibrosis was associated with increased risk for iHF, hHF, and all-cause mortality in the general population and all-cause mortality and CV mortality in the HF patient group (all p < 0.05). Conclusion Hepatic steatosis and/or advanced fibrosis as assessed by FLI and BARD score was significantly associated with the risk of HF and mortality.

Download Full-text

Novel gene variants associated with cardiovascular disease in systemic lupus erythematosus and rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-212614 ◽

2018 ◽

Vol 77 (7) ◽

pp. 1063-1069 ◽

Cited By ~ 8

Author(s):

Dag Leonard ◽

Elisabet Svenungsson ◽

Johanna Dahlqvist ◽

Andrei Alexsson ◽

Lisbeth Ärlestig ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Disease ◽

General Population ◽

Lupus Erythematosus ◽

Risk Allele ◽

Snp Array ◽

Inflammatory Rheumatic Diseases ◽

Systemic Lupus ◽

Increased Risk

ObjectivesPatients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) have increased risk of cardiovascular disease (CVD). We investigated whether single nucleotide polymorphisms (SNPs) at autoimmunity risk loci were associated with CVD in SLE and RA.MethodsPatients with SLE (n=1045) were genotyped using the 200K Immunochip SNP array (Illumina). The allele frequency was compared between patients with and without different manifestations of CVD. Results were replicated in a second SLE cohort (n=1043) and in an RA cohort (n=824). We analysed publicly available genetic data from general population, performed electrophoretic mobility shift assays and measured cytokine levels and occurrence of antiphospholipid antibodies (aPLs).ResultsWe identified two new putative risk loci associated with increased risk for CVD in two SLE populations, which remained after adjustment for traditional CVD risk factors. An IL19 risk allele, rs17581834(T) was associated with stroke/myocardial infarction (MI) in SLE (OR 2.3 (1.5 to 3.4), P=8.5×10−5) and RA (OR 2.8 (1.4 to 5.6), P=3.8×10−3), meta-analysis (OR 2.5 (2.0 to 2.9), P=3.5×10−7), but not in population controls. The IL19 risk allele affected protein binding, and SLE patients with the risk allele had increased levels of plasma-IL10 (P=0.004) and aPL (P=0.01). An SRP54-AS1 risk allele, rs799454(G) was associated with stroke/transient ischaemic attack in SLE (OR 1.7 (1.3 to 2.2), P=2.5×10−5) but not in RA. The SRP54-AS1 risk allele is an expression quantitative trait locus for four genes.ConclusionsThe IL19 risk allele was associated with stroke/MI in SLE and RA, but not in the general population, indicating that shared immune pathways may be involved in the CVD pathogenesis in inflammatory rheumatic diseases.

Download Full-text