Competition Catalyst Grant 2018-19

Application Metrics:  2/8 Applications Funded

Principal Investigator:  Dr. Murray B. Urowitz

Institution:  University Health Network

Project Title:  Identifying Antimalarial-Induced Heart Damage in Systemic Lupus Erythematosus

Funding Received:  $35,000 Awarded

Project Lay Summary:  Most patients with systemic lupus erythematosus (SLE) use antimalarials (AM) for many years, if not for life. Eye toxicity is a well-known side effect and patients are required to have an ophthalmology examination every 6-12 months. Heart damage has also been reported as a consequence of prolonged AM treatment, although sporadically. In such cases, AM are deposited in the heart and may cause heart failure and syncope. Diagnosis is usually delayed and almost half of the patients who developed this complication died. We aim to evaluate specific heart biomarkers (blood tests, namely troponin and brain natriuretic peptide, BNP) in the early identification of AM-induced heart damage.

Our preliminary studies led to early diagnosis in a small series of patients. Two hundred fifty patients will be screened for troponin and BNP. We expect that 20 patients will have abnormal biomarkers. Twenty patients with normal biomarkers (of the same age and sex) will comprise the control group. All patients will undergo cardiological investigations to exclude other causes of heart damage and identify how AM affect the structure and function of the heart.

Three distinguished academic centers will collaborate for this project with a team consisting of rheumatologists, cardiologists and radiologists. It is anticipated that the project will be completed in two years and render these biomarkers valuable in identifying subclinical heart damage. The impact on lupus patients who are taking AM for prolonged periods will be significant since early detection of heart damage will lead to improved survival.