Lupus & antiphospholipid syndrome
Predictors of relapse and drivers of damage in SLE-associated thrombocytopenia: a long-term cohort study with comparative literature analysis
Authors' conclusion
aPL positivity is associated with relapse of thrombocytopenia in SLE. While severe thrombocytopenia can lead to bleeding complications, long-term organ damage is primarily caused by cumulative exposure to glucocorticoids used to treat the relapsing disease.
Study context
- Population
- SLE patients with thrombocytopenia (platelets <100 × 109/l), followed between 1983 and 202590 acute/acute-on-chronic
- Participants
- 105 patients
- Outcome
- Predictors of relapse of SLE-associated immune thrombocytopenia
Methodological detailssingle-centre, multivariable logistic regression
- Single-centre
- Multivariable logistic regression
Main finding
As reported in the abstract
Relapse (acute/acute-on-chronic thrombocytopenia)
Relapse
30
33%
aPL positivity, independent predictor of relapse, OR
3.38
95% CI 1.19–9.58
Higher baseline SLEDAI-2K, inversely associated with relapse, OR
0.91
95% CI 0.85–0.97
Observational data: associations, not effects.
Further findings
- Damage accrual in cohort
- 61%
- Cumulative GC dose, primary independent driver of damage, OR per g (P = 0.005)
- 1.056/g
- Neither thrombocytopenia severity nor number of relapses independently predicted damage
Safety
Major bleeding events
- Major bleeding
- 13%
- Significantly increased frequency with platelets below 30 × 109/l (P = 0.003)
Original publication
Predictors of relapse and drivers of damage in SLE-associated thrombocytopenia: a long-term cohort study with comparative literature analysis. Rheumatology (Oxford). Published 20 April 2026. doi:10.
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