Therapy Insight: cardiovascular disease in pediatric systemic lupus erythematosus.

Published

Journal Article (Review)

In 15-20% of cases, systemic lupus erythematosus (SLE) presents before the age of 18 years, and such early-onset SLE seems to be particularly severe. SLE is an independent risk factor for premature atherosclerosis and death in young, premenopausal women with SLE, even after controlling for traditional cardiovascular risk factors. Children and adolescents with SLE are particularly susceptible to this long-term threat to their cardiovascular health because they have an increased disease severity and a lengthy disease burden. Factors that contribute to premature atherosclerosis include the inflammatory and immune abnormalities that are intrinsic to SLE, primary dyslipidemias, and the secondary effects of treatments such as corticosteroids. However, few rheumatologists provide appropriate preventive or management strategies for the increased atherosclerosis risk in this age-group. Screening should be performed on a regular basis, including evaluation of, and counseling for, traditional risk factors. Studies of treatment in pediatric patients are limited, and treatment strategies are often extrapolated from adult studies. Statins hold promise because they have both lipid-lowering and anti-inflammatory effects. There have been few studies of the use of statins in adults or adolescents with SLE; however, trials are currently underway to address the safety and efficacy of statin use in pediatric SLE.

Full Text

Duke Authors

Cited Authors

  • Sandborg, C; Ardoin, SP; Schanberg, L

Published Date

  • May 2008

Published In

Volume / Issue

  • 4 / 5

Start / End Page

  • 258 - 265

PubMed ID

  • 18349862

Pubmed Central ID

  • 18349862

Electronic International Standard Serial Number (EISSN)

  • 1745-8390

International Standard Serial Number (ISSN)

  • 1745-8382

Digital Object Identifier (DOI)

  • 10.1038/ncprheum0789

Language

  • eng