Objectives Current data on arterial and venous thrombotic events (ATE & VTE) and cardiovascular (CV) risk management in European systemic lupus erythematosus (SLE) population are limited. This study aimed to investigate the incidence and risk of thrombotic events and all-cause death in an Italian SLE cohort over the past decade, along with its pharmacotherapy. Methods Incident SLE cases between 2010 and 2019 were identified using administrative health databases of the Lombardy Region. The association between SLE and outcomes, compared with age- and sex-matched controls, was reported as incidence rate per 1000 person-years and as adjusted hazard ratios with 95% confidence intervals. Results Overall, 2133 SLE patients and 21 283 no-SLE individuals were included. A higher incidence rate of ATE (4.22 vs 2.26 1000 PY), VTE (1.85 vs 0.67 1000 PY,) and all-cause death (15.18 vs 6.22 1000 PY) was reported in SLE patients than in those without (p< 0.0001) as well as an increased risk of ATE (HR, 1.65; 95% CI, 1.20–2.26), VTE (HR, 2.25; 95% CI, 1.35–3.74), and all-cause death (HR, 1.81; 95% CI, 1.52–2.15). After SLE diagnoses, hydroxychloroquine and glucocorticoids were prescribed for at least 60% of patients. Additionally, a higher exposure to cardiovascular medications was also seen in SLE patients. Conclusion Our findings confirmed higher risks of ATE, VTE and all-cause death in SLE patients. While increased CV medications use after SLE diagnoses suggests heightened awareness to CV risk profile, more attention is required to balance SLE disease activity with minimizing exposure to drugs associated with exacerbating CV risk.

中文翻译：

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系统性红斑狼疮患者动脉和静脉血栓形成事件的发生率和风险：一项基于人群的研究


目标 目前关于欧洲系统性红斑狼疮（SLE）人群的动脉和静脉血栓事件（ATE & VTE）以及心血管（CV）风险管理的数据有限。本研究旨在调查过去十年意大利 SLE 队列血栓形成事件和全因死亡的发生率和风险，以及其药物治疗。方法 使用伦巴第大区的行政健康数据库确定 2010 年至 2019 年间的事件 SLE 病例。与年龄和性别匹配的对照组相比，SLE 与结局之间的关联报告为每 1000 人年的发病率和调整后的风险比和 95% 置信区间。结果 共纳入 2133 例 SLE 患者和 21 283 例无 SLE 个体。据报道，SLE 患者的 ATE （4.22 vs 2.26 1000 PY）、VTE （1.85 vs 0.67 1000 PY，） 和全因死亡 （15.18 vs 6.22 1000 PY） 的发生率高于无 SLE 患者 （p< 0.0001），并且 ATE （HR， 1.65;95% CI， 1.20–2.26）、VTE （HR， 2.25;95% CI， 1.35-3.74）和全因死亡（HR，1.81;95% CI，1.52-2.15）。在诊断为 SLE 后，至少 60% 的患者服用羟氯喹和糖皮质激素。此外，SLE 患者对心血管药物的暴露也更高。结论 我们的研究结果证实 SLE 患者发生 ATE 、 VTE 和全因死亡的风险更高。虽然 SLE 诊断后 CV 药物使用的增加表明对 CV 风险状况的认识有所提高，但需要更多关注平衡 SLE 疾病活动与尽量减少与加剧 CV 风险相关的药物暴露。