Systemic lupus erythematosus and cardiovascular risk: clinical score, pharmacological and nonpharmacological therapy aspects: a systematic review

Introduction: Patients with Systemic Lupus Erythematosus (SLE) have high rates of cardiovascular risk (CVR). Objectives: Perform a systematic review and meta-analyses, assessing the impact of clinical scores and the use of drug treatments. Method: A systematic review and meta-analyses were carried out, based on the entire structure of the Cochrane handbook, using a PICO strategy (Patient or Problem: SLE; Intervention: clinical scores, drug and non-drug treatment; Control or Comparison: control individuals; Outcomes: atherosclerosis and/or cardiovascular risk), in order to identify studies that addressed these outcomes. Results: A total of 4030 articles were identified, 4 articles were selected in order to identify the CVR through the Framingham score. The meta-analyses identified a non-impact of the Framingham score in relation to the CVR (mean difference: 0.18 [-0.49, 0.86] 95% CI) (p=0.53), 3 studies evaluated the CVR by the use of corticosteroid therapy, it was 1.32 [0.91, 1.93] 95% CI) (p=0.14), but without statistical significance; in relation to the use of hydroxychloroquine, revealed a protective factor of CVR of 0.18 [0.06, 0.56] 95%CI) (p=0.003). Conclusion: There is a need for a more specific clinical score to signal CVR in SLE, the use of drug and non-drug treatment must weigh risks and benefits.