Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

The Protective Effect of Antimalarials On Thrombovascular Events In Latin American Systemic Lupus Erythematosus Patients.

Pons-Estel1,  Guillermo J., Alarcon2,  Graciela S., Wojdyla3,  Daniel, Marcos4,  Ana I., Alvarellos5,  Alejandro J., Iglesias-Gamarra6,  Antonio A., Esteva-Spinetti7,  Maria H.

Servicio de Enfermedades Autoinmunes, Hospital Clìnic Barcelona, Barcelona, Spain
Universidad de Antioquia, Hospital Universitario "San Vicente de Paul", Medellín, Colombia
Catholic University of Chile, Santiago, Chile
Centro de Investigaciones Médico Quirúrgicas, Habana, La Habana, Cuba
Hospital de Especialidades Miguel Hidalgo, Aguascalientes, Mexico
Almenara Hospital IPSs, Lima, Peru
Hospital Provincial de Rosario, Rosario, Argentina
University of Alabama at Birmingham, Birmingham, AL
Universidad Nacional de Rosario, Argentina, Rosario, Argentina
Hospital Interzonal General de Agudos "General San Martin, La Plata, La Plata, Argentina
Hospital Privado, Cordoba, Argentina
Universidad Nacional, Bogota, Colombia
Centro Clinico San Cristobal, San Cristobal, Venezuela
Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Campinas, Brazil
Faculdade de Medicina, Universidade Federal de Goias, Goiania, Brazil


Antimalarials (AMs) have shown to exert a thromboprotective effect in systemic lupus erythematosus (SLE), but studies thus far have been limited to North American and European patients. This study was conducted to assess whether a similar effect is observed in Latin American patients with SLE.


SLE patients with a recent diagnosis (<=2 years) recruited and followed longitudinally as part of the GLADEL cohort were examined to establish risk factors for thrombotic events (TEs) and the possible preventive role of AMs. The outcome variable was defined as the presence of an arterial or venous thrombotic event during follow up. AM use was considered present (ever used) or absent (never used). After controlling for possible confounding variables identified in univariable analysis, the use of AM drugs was assessed for its effects on the development of TEs in cohort patients and by Cox proportional hazards regression analyses.


Of the 1,480 patients included in the GLADEL cohort, 1,213 (82%) were considered AMs users. Thrombosis occurred in 87 (5.9%) of the patients during a median follow up time of 64 (range 12–98) months. After adjustment for potential confounders in the Cox proportional hazards regression model, AM use was associated with a 39% reduction in the rate of TEs (hazard ratio 0.61, 95% CI 0.40–0.95). Other variables significantly associated with TEs are depicted in Table 1.

Table 1. Effects of AMs drugs on the development of TEs in SLE patients from the GLADEL cohort by multivariable Cox proportional hazards regression analysis.

ParameterHR95% CIP Value
Antimalarial use0.6120.400.950.0288
Female sex0.4860.280.840.0096
Antiphospholipid antibodies1.6891.012.820.0443
Any Hospitalization2.2001.393.480.0008
Aspirin/Anticoagulant use2.1561.144.070.0181
Thrombosis Previous to SLE Diagnosis3.6881.857.350.0002


After adjusting for possible confounding factors related to AM use, a clear protective effect of AM in the development of TEs in SLE patients from this Latin American cohort was observed.

To cite this abstract, please use the following information:
Pons-Estel, Guillermo J., Alarcon, Graciela S., Wojdyla, Daniel, Marcos, Ana I., Alvarellos, Alejandro J., Iglesias-Gamarra, Antonio A., et al; The Protective Effect of Antimalarials On Thrombovascular Events In Latin American Systemic Lupus Erythematosus Patients. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :783

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