Usage of drugs for cardiovascular diseases is increased in systemic lupus erythematosus (SLE) patients already before diagnosis of SLE

Abstract

Objective: Systemic lupus erythematosus (SLE) patients are considered as a high-risk population for cardiovascular diseases (CVDs). To explore whether their risk is increased already in preclinical episodes of the disease, we have studied the usage of CVD drugs in incident SLE cases five years before diagnosis of SLE compared to the population controls. Methods: Adult SLE incident patients (age ≥18 years) from 2004 through 2014 were identified from a nationwide register. The date of granted reimbursement for SLE medication was defined as the date of diagnosis (index day). For each patient, three population controls were matched for age, sex and residence on the index day. The patients and controls were linked to the drug purchase register. All purchases of CVD drugs (Anatomical Therapeutic Chemical (ATC) - codes of C01-C04, C07-C09) and separately C10 were recorded in half-year periods over five years before the index day. Results: A total of 653 SLE patients (mean age 45.7±15.9 years, 83% females) and 1924 population controls were found. Over five years before the index day, the proportion of SLE patients with purchased CVD drugs (46.7%) was greater compared to the controls (28.5%) (p<0.001). The relative risk for purchases started to increase more steeply during the last half-year period before SLE diagnosis. There was no significant difference in lipid-modifying agents between groups. Conclusion: Our finding that among SLE patients the use of CVD drugs was more common compared to their control population suggests increased CVD risk already before the diagnosis of SLE.