Department of Pediatrics, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, 630 W. 168th Street, New York, NY, 10032-3702, USA.
Department of Medicine, Division of Rheumatology and Immunology, The Ohio State University, 370 W. 9th Ave, Columbus, OH, 43210, USA.
Pediatr Rheumatol Online J. 2021 Feb 16;19(1):15. doi: 10.1186/s12969-021-00504-6.
Patients with systemic lupus erythematous have a significantly increased risk of cardiovascular disease, which is not fully explained by traditional cardiovascular disease risk factors. Despite increasing life expectancy in patients with systemic lupus erythematous, mortality due to cardiovascular disease, the major cause of death in these patients, has not changed. Children with lupus suffer from more aggressive disease compared to their adult counterparts, and there is a growing concern for their increased risk of cardiovascular disease as they age. BODY: There is an unmet need for therapies to address the increased risk of cardiovascular disease in childhood-onset lupus. Colchicine has many anti-inflammatory and cardiovascular protective properties, including inhibition of IL-1β and IL-18 activity, key proinflammatory cytokines that are predictive of future adverse cardiovascular events. In the Colchicine Cardiovascular Outcomes Trial (COLCOT), colchicine was recently found to have significant benefit with minimal risk in adults with previous myocardial infarction for prevention of secondary vascular disease. While adult studies are promising, no studies have been conducted in pediatric patients to investigate colchicine's potential for cardiovascular protection in children and adolescents with lupus.
Studies investigating colchicine's potential role for cardiovascular protection are needed in pediatric patients with systemic lupus erythematous.
系统性红斑狼疮患者发生心血管疾病的风险显著增加，而这一风险不能仅用传统心血管疾病危险因素来解释。尽管系统性红斑狼疮患者的预期寿命有所延长，但导致患者死亡的主要原因——心血管疾病的死亡率并未改变。与成年患者相比，狼疮儿童的疾病更为严重，随着年龄的增长，他们患心血管疾病的风险增加，这引起了人们越来越多的关注。
针对儿童发病的狼疮患者心血管疾病风险增加这一问题，目前仍存在治疗需求。秋水仙碱具有多种抗炎和心血管保护特性，包括抑制白细胞介素-1β和白细胞介素-18 的活性，而白细胞介素-1β和白细胞介素-18 是预测未来不良心血管事件的关键促炎细胞因子。在秋水仙碱心血管结局试验（COLCOT）中，秋水仙碱在预防成人既往心肌梗死患者的二级血管疾病方面显示出显著获益，且风险极小。虽然成人研究结果很有前景，但尚未在儿科患者中开展研究以评估秋水仙碱在狼疮儿童和青少年中的心血管保护作用。
有必要在系统性红斑狼疮的儿科患者中开展研究，以评估秋水仙碱在心血管保护方面的潜在作用。
