Wednesday, 22 Jan 2020

You are here

Protective Effects of ASA and Vasodilators in Systemic Sclerosis

A large cohort study suggests that the use of vasodilators and aspirin (ASA) in systemic sclerosis (SSc) may yield favorable  cardiovascular outcomes.

Among 601 SSc patients followed since December 2012, they found that 24% received no vasodilators and 76% were on vasodilators ((ie, calcium channel blockers and/or ACE inhibitors or angiotensin II receptor blockers or combinations).  Of the latter 89/453 were on either endothelin receptor antagonists or PDE5 inhibitors or prostanoids (aspirin).

With a total of 914 patient-years of follow-up, they observed 12 ventricular arrhythmias, 5 Q waves, 40 cardiac blocks, 6 pacemaker implantations and 19 reduced LVEF and/or congestive heart failure (CHF) events.

Vasodilator therapy was associated with a lower risk of ventricular arrhythmias (p=0.03). 

Low-dose acetylsalicylic acid (ASA) also had a lower risk of cardiac blocks, Q waves and/or pacemaker implantation (p=0.02).

Active disease was associated with worse cardiac outcomes, including LVEF <55%, CHF, cardiac blocks, Q waves and  pacemaker implantation (p=0.05).

Vasodilators and ASA may have a cardiovascular protective effect in systemic sclerosis patients.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Steroid-Sparing Effect of Tocilizumab in Refractory Takayasu Arteritis

A controlled clinical trial has shown that giving the IL-6 receptor antibody, tocilizumab (TCZ), to  patients with Takayasu arteritis (TAK) results in clinical efficacy and has a steroid sparing efffect.

TULIP2 - Anifrolumab Succeeds in Lupus

NEJM has published the results of the TULIP2 trial with anifrolumab, an alpha interferon blocker, in the treatment of systemic lupus erythematosus, showing significant improvement (over placebo) in multiple lupus outcome measures, including BICLA, SRI-4, CLASI and others.

Steroids Up the Risk of Organ Damage in SLE

Lancet Rheumatology has reported the results of a multicenter follow-up study of systemic lupus erythematosus (SLE) patients showing that organ damange is linked to glucocorticoid use, independent of clinical or serological disease activity.

Treatment of Statin-induced anti-HMGCR myopathy

Statin-induced myositis, often with anti-HMGCR autoantibodies can be difficult to manage, Arthritis Research & Therapy yhas published the experience of 55 patient with HMGCR myopathy, demonstrating that while steroid management may be reasonable in select patients, the use of triple steroid/IVIG/SSI was very efficacious in induction.

Best of 2019 - 2019 EULAR Guidelines on Antiphospholipid Syndrome Management

A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.