Cited by 412Systemic Lupus Erythematosus ResearchSystemic Sclerosis and Related DiseasesVenous Thromboembolism Diagnosis and Management

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Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus

Ruiz-Irastorza, G, Egurbide, M-V, Pijoan, J-I, Garmendia, M, Villar, I, Martinez-Berriotxoa, A, Erdozain, J-G, Aguirre, C·2006·Lupus

DOI 10.1177/0961203306071872

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Abstract

Antimalarials have shown beneficial effects on systemic lupus erythematosus (SLE) activity. Our aim was to investigate whether antimalarials protect against thrombosis and influence survival in SLE patients. A prospective cohort including 232 patients with SLE were included in the study at the time of lupus diagnosis. End points were documented thrombosis and death due to any cause. A Cox regression-multiple-failure time survival analysis model was fitted to establish the effect of antimalarials on the development of thrombosis. Kaplan-Meier survival curves and propensity score adjusted-Cox regression analysis were performed to investigate the effect of antimalarials use on survival. Of our subjects, 204 patients (88%) were women. 230 patients (99%) were white. 150 patients (64%) had ever received antimalarials. Median time on antimalarials was 52 months (range three to 228 months). The Cox multiple-failure time survival analysis showed that taking antimalarials was protective against thrombosis (HR 0.28, 95%CI 0.08-0.90), while aPL-positivity (HR 3.16, 95%CI 1.45-6.88) and previous thrombosis (HR 3.85, 95%CI 1.50-9.91) increased the risk of thrombotic events. Twenty-three patients died, 19 of whom (83%) had never received antimalarials. No patient treated with antimalarials died of cardiovascular complications. Cumulative 15-year survival rates were 0.68 for never versus 0.95 for ever treated patients ( P < 0.001). Age at diagnosis and propensity score-adjusted HR for antimalarials ever versus never users was 0.14 (95%CI 0.04-0.48). Our study shows a protective effect of antimalarials against thrombosis and an increased survival of SLE patients taking these drugs. These data support the routine use of antimalarials in all patients with SLE.

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Authors: Ruiz-Irastorza, G., Egurbide, M.-V., Pijoan, J.-I., Garmendia, M., Villar, I., Martinez-Berriotxoa, A., Erdozain, J.-G., & Aguirre, C.
Affiliations: Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain,
University of the Basque Country (ES)
Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain
ORCID: Pijoan, J-I
Erdozain, J-G
Venue: Lupus
Publisher: SAGE Publications
Published: 2006-09
Volume: 15
Issue: 9
Pages: 577-583
ISSN: 0961-2033 (ISSN-L)
1477-0962
DOI: 10.1177/0961203306071872
OpenAlex: W2014873778
Cited by: 411
References: 48
Citations by year: 2026: 11 · 2025: 7 · 2024: 30 · 2023: 24 · 2022: 19 · 2021: 22 · 2020: 29 · 2019: 23 · 2018: 27 · 2017: 17 · 2016: 18 · 2015: 20 · 2014: 28 · 2013: 22 · 2012: 25
FWCI: 11.16
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Lupus (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Health Sciences › Medicine › Rheumatology › Systemic Sclerosis and Related Diseases
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Keywords: antimalarial drugs, systemic lupus erythematosus, thrombosis, survival, antiphospholipid antibodies, cardiovascular complications, mortality, hydroxychloroquine, chloroquine
MeSH terms: Adult, Analysis of Variance, Antimalarials, Cause of Death, Female, Follow-Up Studies, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Prospective Studies, Research Design, Risk Factors, Spain, Thrombosis, Time Factors, Survival Rate, Proportional Hazards Models, Survival Analysis, Treatment Failure, Endpoint Determination

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Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus

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