|
NEW YORK (Reuters Health) Sept 03 - Hydroxychloroquine exerts a "clear protective effect" in terms of survival in patients with systemic lupus erythematosus (SLE), researchers report in the August issue of the Annals of the Rheumatic Diseases.
"This 'old medicine' has significant beneficial effects in patients with lupus," first author Dr. Graciela S. Alarcn from University of Alabama at Birmingham told Reuters Health. "It prevents the occurrence of flares or disease exacerbations and the accrual of organ damage, and now our work indicates that it also increases the patients' probability of survival."
The results are based on analyses performed in a multiethnic cohort of patients with SLE. After a median follow up of 39 months, 61 of 608 patients had died. There were 17 deaths in patients taking hydroxychloroquine at baseline (n = 349, 5%) and 44 in those not taking this drug at the outset (n = 259, 17%; p < 0.0001).
"One hundred and eighty three patients matched for disease duration were randomly chosen as controls for the 61 deceased patients in a proportion of 3:1," the team explains.
In analyses adjusting for a number of variables that differ between those treated and not treated with hydroxychloroquine, treatment with hydroxychloroquine alone had a protective effect on survival, with an odds ratio of 0.128. The protective effect remained when the propensity score was added to the model (OR, 0.319).
"This protective effect of hydroxychloroquine is probably mediated by its ability to prevent the occurrence of flares and damage, both of which can be regarded as mediators of a later outcome such as death," the authors state.
They also point out that antimalarial drugs such as hydroxychloroquine have antithrombotic, antihyperlipidemic, and antihyperglycemic effects, which may "independently contribute to the decreased occurrence of vascular thrombotic events. The ultimate result is an improvement in survival."
"These data suggest that, unless there is a specific contraindication for its use, lupus patients should receive this medication," Dr. Alarcn said. It should be given using established guidelines so that the proper dose is prescribed -- not exceeding 6.5 mg/kg of ideal body weight - and adequate ophthalmological monitoring should be employed.
As hydroxychloroquine is generally well tolerated, "unless side effects occur, it can be administered for the duration of the disease," the authors write.
|
Message
Boards
