Lupus: thrombocytopenia signals risk for end-organ damage, mortality

Takeaway

• A meta-analysis finds that thrombocytopenia in patients with systemic lupus erythematosus (SLE) may be a risk factor for end-organ damage and mortality.

Why this matters

• Clinicians may consider patients with lupus with thrombocytopenia as being of high risk.

Study design

• Meta-analysis of 8 observational studies (n=2158) after search of PubMed, Embase, and Cochrane Library.
• Funding: Science and Technology Planning Project of Guangdong Province, China.

Key results

• Patients with SLE with thrombocytopenia were at more than 3-fold excess risk for end-organ damage (OR, 3.31; P=.031).
• Patients with SLE with thrombocytopenia were at more than 4-fold excess risk for mortality (OR, 4.57; P<.001; I²=60.3%).
  • This excess risk decreased to OR, 2.15 (P<.001; I²=0%) when one of the studies with a high percentage of patients with severe thrombocytopenia was removed.
• Patients with thrombocytopenia with disease duration of <60 months had a higher risk for mortality than thrombocytopenic patients with disease duration ≥60 months (P=.002).

Limitations

• Small number of studies, subjects per study.