Hachulla E1Jais X2Cinquetti G3Clerson P4Rottat L2Launay D5Cottin V6Habib G7Prevot G8Chabanne C9Foïs E10Amoura Z11Mouthon L12Le Guern V12Montani D2Simonneau G2Humbert M2Sobanski V5Sitbon O2French Collaborators Recruiting Members(∗).

ABSTRACT:

BACKGROUND:

Pulmonary arterial hypertension (PAH) is a rare complication of systemic lupus erythematosus (SLE).

METHODS:

We identified all patients with SLE and PAH (SLE-PAH) who were enrolled in the French Pulmonary Hypertension Registry with a diagnosis confirmed by right heart catheterization (RHC). A control group of 101 patients with SLE without known PAH was selected from SLE expert centers participating in the Pulmonary Hypertension Registry. Survival was estimated by the Kaplan-Meier method. Hazard ratios associated with potential predictors of death were estimated using Cox proportional hazard models.

RESULTS:

Of the 69 patients with SLE-PAH identified in the French Pulmonary Hypertension Registry, 51 were included in the study. They did not differ from the control group regarding age, sex, or duration of SLE at the time of the analysis but had a higher frequency of anti-SSA and anti-SSB antibodies. The delay between SLE diagnosis and PAH diagnosis was 4.9 years (range, 2.8-12.9) years. The 3- and 5-year overall survival rates were 89.4% (95% CI, 76.2%-96.5%) and 83.9% (95% CI, 68.8%-92.1%), respectively. The survival rate was significantly better in patients with anti-U1-RNP antibodies (P = .04).

CONCLUSIONS:

Patients with SLE-PAH have an overall 5-year survival rate of 83.9% after the PAH diagnosis. Anti-SSA/SSB antibodies may be a risk factor for PAH, and the presence of anti-U1-RNP antibodies appears to be a protective factor regarding survival.

KEYWORDS:
pulmonary arterial hypertension; survival; systemic lupus erythematosus

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