title: Reduced carotid intima-media thickness in systemic lupus erythematosus patients treated with cyclosporine A.
abstract: BACKGROUND
  Patients with systemic lupus erythematosus (SLE) are at risk of atherosclerosis. An increased carotid intima-media thickness (IMT) is considered to be a marker of early atherosclerosis. Objective To determine influential factors for increased carotid IMT in SLE patients.
  
  
  METHODS
  We evaluated the impact of conventional risk factors for atherosclerosis on carotid IMT in 427 healthy controls and of clinical factors on carotid IMT in 94 SLE patients. Carotid IMT was measured by using a newly developed computer-automated system. Unconditional logistic regression was used to assess the adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CI).
  
  
  RESULTS
  Multivariate-adjusted mean carotid IMT (mm) was significantly reduced in SLE patients (0.51, 95 % CI = 0.36-0.66) compared to healthy controls (0.55, 95 % CI = 0.40-0.70) (P = 0.003). The SLE Disease Activity Index (SLEDAI) was associated with carotid IMT in a dose-dependent manner (Ptrend = 0.041). The current use of cyclosporine A (adjusted OR = 0.02, 95 % CI = 0.01-0.40, P = 0.011) and a history of steroid pulse therapy (adjusted OR = 0.01, 95 % CI = 0.01-0.25, P = 0.006) were significantly associated with a decreased risk of increased carotid IMT.
  
  
  CONCLUSIONS
  Our findings suggest that the current use of cyclosporine A can protect against increased carotid IMT, leading to a decreased risk of arteriosclerosis. Future studies with a larger sample size need to confirm that this association holds longitudinally.
authors.affiliation: Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences , Fukuoka 812-8582 , Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Oryoji
authors.forename: Chikako
authors.initials: C
authors.lastname: Kiyohara
authors.forename: Takahiko
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsukamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Niiro
authors.forename: Terufumi
authors.initials: T
authors.lastname: Shimoda
authors.forename: Koichi
authors.initials: K
authors.lastname: Akashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yanase
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016572:Cyclosporine / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine