The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.
Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus
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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In the citing paper
“HCQ treatment is currently recommended for SLE patients with persistent moderate-high aPL Ab or LAC+ for primary prevention (grade 1B to 2B recommendation) based on the other beneficial effects of HCQ in SLE (12, 13) and thrombosis (14).”
In the citing paper
“In patients with SLE, long-term exposure to HCQ has consistently been associated with a reduction in both first and recurrent thrombotic events, particularly in those with persistent aPL positivity [6, 7].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [6]
In the citing paper
“Multiple observational studies have consistently shown that long-term antimalarial use reduces both first and recurrent thrombotic events in patients with SLE, particularly among those with persistent antiphospholipid antibodies [6, 7].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [6]
Citations
Cites
The central role of the propensity score in observational studies for causal effects
ROSENBAUM, P. R., & RUBIN, D. B. (1983) · Biometrika · doi:10.1093/biomet/70.1.41 · Cited by 31,241
The 1982 revised criteria for the classification of systemic lupus erythematosus
Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., Mcshane, D. J., Rothfield, N. F., Schaller, J. G., Talal, N., & Winchester, R. J. (1982) · Arthritis & Rheumatism · doi:10.1002/art.1780251101 · Cited by 14,519
Hochberg, M. C. (1997) · Arthritis & Rheumatism · doi:10.1002/art.1780400928 · Cited by 11,409
The Robust Inference for the Cox Proportional Hazards Model
Lin, D. Y., & Wei, L. J. (1989) · Journal of the American Statistical Association · doi:10.1080/01621459.1989.10478874 · Cited by 2,695
Manzi, S., Meilahn, E. N., Rairie, J. E., Conte, C. G., Medsger, T. A., Jansen-McWilliams, L., D’Agostino, R. B., & Kuller, L. H. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009122 · Cited by 1,831
Prevalence and Correlates of Accelerated Atherosclerosis in Systemic Lupus Erythematosus
Roman, M. J., Shanker, B., Davis, A., Lockshin, M. D., Sammaritano, L. R., Simantov, R., Crow, M. K., Schwartz, J. E., Paget, S. A., Devereux, R. B., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035471 · Cited by 1,422
Cervera, R., Khamashta, M. A., Font, J., Sebastiani, G. D., Gil, A., Lavilla, P., Mejía, J. C., Aydintug, A. O., Chwalinska-Sadowska, H., de Ramón, E., et al. (2003) · Medicine · doi:10.1097/01.md.0000091181.93122.55 · Cited by 1,377
Premature Coronary-Artery Atherosclerosis in Systemic Lupus Erythematosus
Asanuma, Y., Oeser, A. M., Shintani, A., Turner, E. L., Olsen, N. J., Fazio, S., Linton, M. F., Raggi, P., & Stein, C. M. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035611 · Cited by 889
Sequential Therapies for Proliferative Lupus Nephritis
Contreras, G. N., Pardo, V., Leclercq, B., Lenz, O., Tozman, E., O'Nan, P., & Roth, D. A. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa031855 · Cited by 815
Kirou, K. A., Lee, C., George, S., Louca, K., Peterson, M. G. E., & Crow, M. K. (2005) · Arthritis & Rheumatism · doi:10.1002/art.21031 · Cited by 702
Research works printed but not linked: 3
- Rosembaum PR , Rubin DB. The central role of propensity scores in estimating dose-response functions . Biometrika 1983; 70: 41-55 .
- 10.1177/0961203396005001031 · DOI · Paper page
- Alarcón GS , McGwin G, Jr. , Fessler BJ et al. “Confounding by indications” partially explains the protective effect of hydroxychloroquine (HCQ) in SLE survival: Data from a multiethnic US cohort . Arthritis Rheum 2005; 52: S726-S726 .
Cited by
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KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases
Rovin, B. H., Adler, S. G., Barratt, J., Bridoux, F., Burdge, K. A., Chan, T. M., Cook, H. T., Fervenza, F. C., Gibson, K. L., Glassock, R. J., et al. (2021) · Kidney International · doi:10.1016/j.kint.2021.05.021 · Cited by 2,735
Ruiz-Irastorza, G., Ramos-Casals, M., Brito-Zeron, P., & Khamashta, M. A. (2010) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.101766 · Cited by 978
Self-citationCervera, R., Serrano, R., Pons-Estel, G. J., Ceberio-Hualde, L., Shoenfeld, Y., de Ramón, E., Buonaiuto, V, Jacobsen, S., Zeher, M. M., Tarr, T., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-204838 · Cited by 974
Systemic lupus erythematosus: Diagnosis and clinical management
Fava, A., & Petri, M. (2018) · Journal of Autoimmunity · doi:10.1016/j.jaut.2018.11.001 · Cited by 818
Treat-to-target in systemic lupus erythematosus: recommendations from an international task force
van Vollenhoven, R., Mosca, M., Bertsias, G. K., Isenberg, D. A., Kuhn, A., Lerstrøm, K., Aringer, M., Bootsma, H., Boumpas, D., Bruce, I. N., et al. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-205139 · Cited by 761
Metadata
- 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
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2006-09
- Volume
- 15
- Issue
- 9
- Pages
- 577-583
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- 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
- 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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