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A recent study conducted by researchers at UT Southwestern Medical Center has revealed a troubling connection between cutaneous lupus erythematosus (CLE), an autoimmune skin disease, and an increased risk for atherosclerotic cardiovascular disease (ASCVD), or the hardening of the arteries. The findings, published in JAMA Dermatology, suggest that patients with CLE should be screened for heart disease at an earlier stage to better manage their cardiovascular health.
While the connection between systemic lupus erythematosus (SLE) and a higher risk of heart disease has been well documented, this new study highlights a similar concern for individuals with CLE, a condition affecting the skin. “While it has been well established that patients with systemic lupus erythematosus (SLE) are at higher risk for cardiovascular disease, those with cutaneous lupus, who generally fall in the milder spectrum of lupus disease, had little clarity about their chances of developing significant heart disease,” explained Dr. Benjamin Chong, Professor of Dermatology and senior author of the study. “This study helps shed light on this knowledge gap and encourages providers to discuss this potential risk with their patients with cutaneous lupus.”
CLE affects at least 80% of people with SLE, but it can also occur on its own. The Centers for Disease Control and Prevention (CDC) estimates that 204,000 people in the United States are living with SLE. While the connection between other inflammatory conditions, such as psoriasis, and ASCVD has been explored, the association between CLE and cardiovascular disease has not been well understood until now.
The researchers utilized the IBM MarketScan Commercial Claims and Encounters Database to analyze data from 306,770 adults, all over the age of 18. These individuals were identified as having CLE, SLE, or psoriasis based on medical diagnoses from dermatologists or rheumatologists. The study then compared the prevalence of ASCVD and the incidence of newly diagnosed cardiovascular disease in each group. They also examined how the severity of CLE impacted the risk of heart disease.
The results revealed that patients with CLE had a prevalence and incidence of cardiovascular disease similar to those with SLE, and significantly higher than those with psoriasis or healthy, age-matched individuals. The study also found that more severe cases of CLE, particularly those treated with systemic therapy, had a notably higher prevalence and incidence of ASCVD compared to mild cases.
“Our findings suggest clinicians treating individuals with CLE should consider them at increased risk for ASCVD and evaluate them accordingly,” said Dr. Henry Chen, lead author of the study and a UT Southwestern resident in Dermatology.
The researchers emphasize the importance of early cardiovascular screenings for individuals with CLE, particularly those with severe forms of the disease who may be undergoing systemic treatments. The study underscores the need for healthcare providers to be vigilant in monitoring the cardiovascular health of patients with cutaneous lupus.
For further information, the study can be accessed in JAMA Dermatology under the title, Incidence and Prevalence of Atherosclerotic Cardiovascular Disease in Cutaneous Lupus Erythematosus.
Source: Henry W. Chen et al, JAMA Dermatology, 2024. DOI: 10.1001/jamadermatol.2024.4991
