Study: Cutaneous Lupus Linked with Elevated Cardiovascular Disease Risk

Key Takeaways

• Cutaneous lupus erythematosus (CLE) patients have a significantly increased risk for atherosclerotic cardiovascular disease (ASCVD) comparable to systemic lupus erythematosus (SLE), but higher than psoriasis.
• Incident ASCVD rates over three years were highest in patients with SLE, followed by those CLE, psoriasis, and controls.
• ASCVD screening and preventive strategies for CLE patients should be considered, researchers said. 

Patients with cutaneous lupus erythematosus (CLE) face an elevated risk of atherosclerotic cardiovascular disease (ASCVD), comparable to that seen in systemic lupus erythematosus (SLE), according to a new study.

Authors of the retrospective cohort study analyzed health records of 8,138 patients with CLE, 24,675 with SLE, 192,577 with psoriasis, and 81,380 controls, comparing ASCVD incidence and prevalence in individuals with CLE, SLE, psoriasis, and a disease-free control group. They used multivariable logistic regression and Cox proportional hazards models to assessed ASCVD risk across these populations, adjusting for cardiovascular risk factors. The prevalence of ASCVD was higher in CLE (odds ratio [OR], 1.72; 95% CI, 1.45 to 2.02) and SLE (OR = 2.41; 95% CI, 2.14 to 2.70) compared to controls at baseline, but not for psoriasis (OR = 1.03; 95% CI, 0.95 to 1.11).

Incident ASCVD rates over a median three-year follow-up were highest in SLE patients (24.8 per 1000 person-years), followed by CLE (15.2), psoriasis (14.0), and controls (10.3). Multivariable Cox regression showed that CLE increased incident ASCVD risk (HR = 1.32; 95% CI, 1.13 to 1.55), though less than SLE (HR = 2.23; 95% CI, 2.05 to 2.43). Psoriasis patients did not have an elevated risk (HR = 1.06; 95% CI, 0.99 to 1.13).

"In this retrospective matched longitudinal cohort study, CLE was associated with an increased risk for ASCVD, similar to the risk in SLE but higher than the risk in psoriasis," the researchers concluded. "The role of comorbidities that augment ASCVD risk like smoking status should be further investigated. Clinicians treating patients with CLE can consider them at increased ASCVD risk and institute appropriate screening tests."

Source: Chen H, et al. JAMA Dermatology. 2024. Doi:10.1001/jamadermatol.2024.4991