PB1163 - Systemic lupus erythematosus and rheumatoid arthritis: evaluation of the hemostatic profile using the thrombin generation test

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Maria das Graças Carvalho, PhD

PhD, Full Professor
Department of Clinical and Toxicological Analysis - Faculty of Pharmacy, Federal University of Minas Gerais, Brazil
Belo Horizonte, Minas Gerais, Brazil

Co-Author(s)

LP

Licia M. Paes

Pharmacist, MSc
Faculty of Pharmacy- Federal University of Minas Gerais
Belo Horizonte, Minas Gerais, Brazil
LA

Luan C. V. Alves

Biomedic, MSc.
Faculty of Pharmacy, Federal University of Minas Gerais
Belo Horizonte, Minas Gerais, Brazil
VT

Vicente de Paulo C.P. Toledo

PhD, Associate Professor
Faculty of Pharmacy, Federal University of Minas Gerais-Brazil
Belo Horizonte, Minas Gerais, Brazil
GF

Gilda A. Ferreira

MD, PhD, Associate Professor
Faculty of Medicine, Federal University of Minas Gerais-Brazil
Belo Horizonte, Minas Gerais, Brazil
PP

Paulo M. Pádua

MD,PhD
Faculty of Medicine -Federal University of Minas Gerais-Brazil
Belo Horizonte, Minas Gerais, Brazil
GB

Gilcelia C.S. Bernardes

MSc/PhD student
Federal University of São João del-Rei (UFSJ), Campus Centro-Oeste Dona Lindu, Divinópolis, Minas Gerais, Brazil.
Divinópolis, Minas Gerais, Brazil
FL

Felipe P. Lasmar

Medical Student
Faculty of Medical Sciences of Minas Gerais- Brazil
Belo Horizonte, Minas Gerais, Brazil
IS

Ieda de Fatima Silva

PhD, Associate Professor
Faculty of Pharmacy, Federal University of Minas Gerais-Brazil
Belo Horizonte, Minas Gerais, Brazil
RD

Rita C.F. Duarte

Pharmacist- PhD
Faculty of Pharmacy, Federal University of Minas Gerais / Bioclin-Quibasa
Belo Horizonte, Minas Gerais, Brazil

Background: Autoimmune diseases such as Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are characterized by multiple organ involvement, autoantibody production, chronic inflammation, cytopenias and hemostatic abnormalities, with frequent thrombotic events. SLE and RA constitute in themselves a state of hypercoagulability, which may be assessed through the use of thrombin generation tests (TGT).

Aims: To evaluate the impact of SLE and RA on the hemostatic profile in comparison with a group of healthy women (controls).

Methods: A total of 47 women participated in this cross-sectional study (SLE, n=21; RA, n=10 and Controls, n=16). Possible hemostatic changes were investigated using TGT (CAT method), with low and high concentrations of Tissue Factor (TF). Patients' SLE activity was measured using SLEDAI-2K (Systemic Lupus Erythematosus Disease Activity Index), a standardized index created to assess disease progression.
Informed consent was obtained and the study approved by local Ethics Committee.

Results: TGT parameters indicated greater activation of the hemostatic mechanism in patients with SLE (mainly those with SLEDAI>4), compared to RA and controls, based on Peak values (p < 0.001 for both). ETP (Endogen Thrombin Potential) values were higher than those observed for RA (p= 0.017). When the SLE group was subdivided into subgroups with SLEDAI-2K≤4 and >4, the Peak values in both TF concentrations were significantly higher in those with the highest score (Low TF: p=0.042; High TF: p= 0.037), reflecting the impact of the inflammatory process on the hemostatic system.

Conclusion(s): A greater coagulation activation was observed in patients with SLE, especially in those with greater activity, which reflects a relationship between the disease's own inflammation and hemostatic changes, as expected. The joint analysis of the data reinforces the potential of the TGT for use in the Clinic in the context of SLE.
Financial support: CAPES, CNPq and FAPEMIG - Brazil