Atherosclerosis Progression in the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) Trial Can Be Predicted in Young People With Juvenile‐Onset Systemic Lupus Erythematosus Using a Novel Lipid Metabolomic Signature
Authors' conclusion
Significant baseline heterogeneity and distinct subclinical atherosclerosis progression trajectories exist in JSLE. Metabolomic signatures can predict atherosclerosis progression in some patients with JSLE with relevance for clinical trial stratification.
Study context
- Population
- Young people with juvenile-onset SLE in the APPLE trial
- Participants
- 151 people
- Comparison
- High vs low carotid intima-media thickness (CIMT) progression in JSLE; atorvastatin vs placebo
- Atorvastatinn = 61
- Placebon = 60reference
- Primary endpoint
- CIMT progression
- Follow-up
- 36 months
Methodological detailsunsupervised clustering, machine learning, metabolomic
- Unsupervised clustering
- Machine learning
- Metabolomic
Primary result
As reported in the abstract
| Group | AUC (baseline metabolomic signature predicting high CIMT progression) |
|---|---|
| Placebo | 80.7% |
Placebo
AUC (baseline metabolomic signature predicting high CIMT progression)80.7%
- Atorvastatin: high atherosclerosis progression despite reduced low-density lipoprotein (LDL) cholesterol, not predicted by metabolomic biomarkers
- 36%
Further findings
| Outcome | P value |
|---|---|
| Total cholesterol, high vs low CIMT progression (placebo)Higher in high progression, within reference range | P = 0.001 |
| LDL cholesterol, high vs low CIMT progression (placebo)Higher in high progression, within reference range | P = 0.002 |
Original publication
Atherosclerosis Progression in the APPLE Trial Can Be Predicted in Young People With Juvenile‐Onset Systemic Lupus Erythematosus Using a Novel Lipid Metabolomic Signature. Arthritis Rheumatol. Published 19 December 2023. doi:10.
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