Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: A longitudinal data analysis
Abstract
Purpose To determine the effect of prednisone dose and hydroxychloroquine dose on the coronary artery disease risk factors serum cholesterol level, mean arterial blood pressure, and weight in patients with systemic lupus erythematosus.Patients and methods A longitudinal cohort study of 264 patients with systemic lupus erythematosus was conducted. For all patients in the cohort, serum cholesterol, mean arterial pressure, weight, prednisone dose, hydroxychloroquine dose, and other potential confounding variables were recorded at each visit. Regression analysis appropriate for longitudinal data was used to assess the effect of prednisone on serum cholesterol and mean arterial pressure. To assess the effect of prednisone on weight, patients' weights were compared 90 days before and after a 10-mg or 20-mg increase in prednisone.Results A total of 3,027 patient visits were analyzed. In the regression model for serum cholesterol, a change in prednisone dose of 10 mg was associated with a change in cholesterol of 7.5 +/- 1.46 (SE) mg% after adjustment for the other significant variables in the model, including sex, race, hydroxychloroquine dose, and proteinuria. In the regression model for hydroxychloroquine, the 200-mg and the 400-mg dose were both associated with lower serum cholesterol (8.9 +/- 3.44 SE mg%). In the regression model for mean arterial blood pressure, a 10-mg change in prednisone dose led to a change in mean arterial blood pressure of 1.1 mm Hg after adjustment for age, weight, and antihypertensive drug use. A 10-mg increase in prednisone dose was associated with a mean weight change of 5.50 +/- 1.23 (SE) lb.Conclusions Changes in prednisone dose led to definable changes in risk factors for coronary artery disease, even after adjustment for other variables known to affect these risk factors. According to longitudinal regression analysis, hydroxychloroquine therapy was associated with lower serum cholesterol.
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Prior retrospective and prospective studies have shown that hydroxychloroquine lowers the risk of arterial and venous thrombosis in systemic lupus erythematosus.
“Multiple retrospective and a few prospective studies (3–13) have found that hydroxychloroquine (HCQ) reduces the risk of arterial and venous thrombosis.”
From Association of Higher Hydroxychloroquine Blood Levels With Reduced Thrombosis Risk in Systemic Lupus Erythematosus (2021) · cites this paper as [5]
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“comorbidity factors including diabetes (20) and hyperlipidemia (5).”
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- Authors
- Petri, M., Lakatta, C., Magder, L., & Goldman, D.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Petri, Michelle
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1994-03
- Volume
- 96
- Issue
- 3
- Pages
- 254-259
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2021741488
- Cited by
- 323
- References
- 25
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 10 · 2021: 12 · 2020: 8 · 2019: 6 · 2018: 10 · 2017: 14 · 2016: 6 · 2015: 6 · 2014: 16 · 2013: 15 · 2012: 23
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29hl047080-02)
- National Heart, Lung, and Blood Institute (HL 47080-01)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- systemic lupus erythematosus, prednisone, hydroxychloroquine, coronary risk factors, serum cholesterol, mean arterial pressure, body weight, glucocorticoid dose, hypolipidemic effect
- MeSH terms
- Adult, Blood Pressure, Body Weight, Cholesterol, Coronary Disease, Female, Humans, Hydroxychloroquine, Lupus Erythematosus, Systemic, Male, Middle Aged, Prednisone, Regression Analysis, Risk Factors, Linear Models
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