Aspirin Resistance in Systemic Lupus Erythematosus (SLE)
Aspirin Resistance in Systemic Lupus Erythematosus (SLE)
This study examine whether patients with lupus respond to aspirin , and if not, if that is
 related to inflammation. We examine the ability of aspirin to inhibit the production of
 thromboxane in patients with lupus and controls and see if aspirin insensitive thromboxane
 production is inhibited by meloxicam.
Premature cardiovascular disease is a major cause of mortality in patients with systemic
 lupus erythematosus (SLE) with the risk of myocardial infarction increased up to 50-fold. In
 addition to defining the mechanisms for accelerated atherosclerosis it is important to define
 the effects of drugs used to reduce cardiovascular risk in high-risk patients. Low dose
 aspirin, by inhibiting thromboxane A2 biosynthesis, has profound antiplatelet effects, but
 some patients have impaired thromboxane suppression - a phenomenon termed aspirin resistance.
 An explanation is that aspirin-independent thromboxane synthesis may occur through enhanced
 COX-2 activity, as would occur in an inflammatory condition such as lupus. However, little is
 known about the effects of low-dose aspirin in SLE. Thus, we propose to test the following
 hypothesis: 1) that aspirin insensitive thromboxane biosynthesis is increased in patients
 with lupus and is mediated by increased COX-2 activity.
Inclusion Criteria:

 -  Written Informed consent.

 -  Age >18 yrs.

 -  SLE meeting ACR criteria {Tan, Cohen, et al. 1982 1482 /id} for at least 6 months.(SLE
 group)

 -  Stable disease activity as evidenced by no change in immunosuppressive therapy in the
 past 1 month.

 -  If female of childbearing potential must use an effective method of birth control

 Exclusion criteria.

 -  Renal disease (creatinine >1.5 mg/dL, dialysis, 2+ or more proteinuria)

 -  Previous or current history of peptic ulcer disease or gastrointestinal bleed.

 -  Previous or current thromboembolic or ischemic cardiovascular event (stroke,
 myocardial infarction, angina) - can do aspirin part of study.

 -  Currently taking an anticoagulant or antiplatelet agent (besides aspirin).

 -  Thrombocytopenia (platelet count <135,000)

 -  Pregnancy

 -  Allergy to aspirin, NSAIDs

 -  NSAIDs in the previous week