Thrombosis in systemic lupus erythematosus patients: analysis of COMOSLE-Egypt study population

Introduction. Thrombosis is prevalent in patients with systemic lupus erythematosus (SLE). However, studies focusing on the impact of thrombosis on damage and survival are still insufficient. The aim of this study was to determine the frequency of thrombosis in a group of Egyptian SLE patients and to identify its impact on damage and survival. Material and methods. This study is an analysis of a retrospective multicenter COMOSLE study. SLE patients with thrombosis were compared to those without thrombosis regarding demographic data, clinical features, laboratory investigations, medications used, systemic lupus erythematosus disease activity index (SLEDAI) at baseline, systemic lupus international collaborating clinics/ACR damage index (SLICC) at last visit, and mortality. Risk factors for thrombosis were analyzed. Results. Out of 902 studied SLE patients, 142 patients (15.7%) were found to have TE along the course of the disease. Arterial and venous thrombosis were significantly associated with damage risk (OR: 2.44, OR: 1.07, p < 0.001, p < 0.001, CI: 1.71–2.78, CI: 0.74–1.40 respectively). Arterial and venous thrombosis were significantly associated with lower survival (HR: 2.05, HR: 1.66, p = 0.015, p = 0.03, CI: 1.15–3.67, CI: 1.05–2.63, respectively). Triple-positive antiphospholipid antibodies (aPL abs) were significantly associated with damage (OR: 1.205, p = 0.001, CI: 0.50–1.91). The 5-year overall survival in the thrombosis group and those without was 93.8% and 94.9%, respectively, while the 10-year overall survival results were 84.6% and 90.2% (p = 0.001). Conclusions. Thrombosis in SLE is primarily associated with aPL, dyslipidemia, and hypertension rather than vasculitis. Thrombosis, especially arterial thrombosis, was found to be significantly associated with increased damage risk and lower survival in SLE patients. Triple-positive aPL abs were significantly associated with damage risk.