Table 3.

Preventative Approaches for SLE-accelerated Atherosclerosis

Preventive approach	Experimental data	Clinical data
Rituximab	Reduced atherosclerosis in ApoE−/− and LDLr−/− mice (59,60)	EXPLORER and LUNAR trials did not reach treatment goals (90,91)
		Development of ulcerative colitis (92) or psoriasis (93) following treatment
Belimumab	BAFF-R−/−, ApoE−/− mice have reduced atherosclerosis (96,97)	Moderately effective for SLE (94)
		Not effective in African American women (95)
CD40	Expansion of Breg through CD40 reduces autoimmunity (65)
All-trans retinoic acid	atRA and TGFβ increase Treg suppressive function (102)	Reduced induction of Treg in SLE T cells by atRA (104)
(atRA)	atRA inhibits Th17 development (103)
Mycophenolate mofetil	Reduced atherosclerosis (107)	Effective in treating SLE (106)
(MMF)	Atherosclerosis, CD4+ T cells in atherosclerotic lesions and peripheral CD4+ T cell activation reduced in LDLr.S/e mice (107)	No effects on CIMT or CAC (109)
Statins	Reduced atherosclerosis in gld.apoE−/− mice (11)	Improved endothelial-dependent vasodilation in SLE (112)
	No effects on atherosclerosis in apoE−/−, Fas−/− mice (110)	LAPS – no effects on CAC, IMT or endothelial activation in SLE (113)
		APPLE – no effect on CIMT in SLE
Hydroxychloroquine		Reduced accumulation of damage in SLE (115)
		Reduced inflammatory cytokines, including IFNα (116)
		Reduced serum cholesterol, reduced LDL cholesterol (117–120)
		Reduced aortic stiffness (121)
		Negative correlation between hydroxychloroquine treatment and atherosclerosis in SLE (88)
ApoA-l and mimetic peptides	Injection of ApoA-l led to decrease in autoimmune-like symptoms and improved Treg function in LDLr−/−, ApoA-l−/− mice (122)
	L-4F reduced piHDL and circulating autoantibodies in apoE−/−, Fas−/− mice (110)
	L-4F and pravastatin increased atherosclerosis but also increased lesion smooth muscle cell content and reduced macrophages in atherosclerotic lesions (110)