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Management of Systemic Lupus Erythematosus

• current smokers had higher risk compared with never smokers
(OR=1.49, 95% CI 1.06 to 2.08)
• ever smokers had higher risk compared with never smokers
(OR=1.54, 95% CI 1.06 to 2.23)

ii. Silica exposure
A meta-analysis showed that the risk of SLE increased with
occupational exposure to free crystalline silica (OR=9.72, 95% CI 1.13
to 83.58). 13, level II-2 An exposure-response effect was also seen for
longer duration of exposure to silica (p for trend=0.01) in a case-control
study: 14, level II-2
• OR for exposure to silica for 1 - 5 years was 4.0 (95% CI 1.2 to
12.9)
• OR for exposure to silica for >5 years was 4.9 (95% CI 1.1 to 21.9)

e. Hormonal (contraceptive and hormone replacement therapy)
A meta-analysis showed an association between hormone replacement
therapy (HRT) exposure and SLE development (RR=1.96, 95%, CI
1.51 to 2.56). However, there was no significant association between
oral contraceptives and SLE. 15, level I There was no mention of the quality
assessment of the observational study used in the meta-analysis.

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