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Hydroxychloroquine improves lipid profiles in rheumatoid arthritis patients

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Hydroxychloroquine may reduce the heightened risk of cardiovascular disease in patients with rheumatoid arthritis. Use of hydroxychloroquine to treat rheumatoid arthritis is associated with reductions in cholesterol and triglycerides, a team with the Geisinger Health System in Danville, Pennsylvania has shown.

Writing in Arthritis Care & Research online November 15, Dr. Androniki Bili and colleagues explain that hydroxychloroquine (HCQ), an antimalarial medication used to treat autoimmune diseases, has been shown to have favorable but modest effects on the lipid profiles of patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis.

However, those studies were small and of short duration, so the team investigated further using the medical records of a cohort of 706 rheumatoid arthritis patient, 256 (36%) of whom had been treated with HCQ at some point. The median duration of HCQ treatment was 1.98 years

After adjusting for demographic features, BMI, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, comorbid conditions, and various medications, the researchers found that HCQ use versus nonuse was associated with an average decrease in LDL of 7.55 mg/dL (p<0.001), an HDL increase of 1.02 mg/dL (p=0.20), a total cholesterol decrease of 7.70 mg/dL (p=0.002), and a decrease in triglycerides of 10.91 mg/dL (p=0.06).

The authors note that HCQ has a weak antiinflammatory effect, but this is not likely to be the reason for the beneficial effect on lipids, and they say the mechanism by which this effect is mediated is uncertain..

Still, Dr. Bili and colleagues conclude, “Although HCQ has only modest disease-modifying effects in the treatment of RA (rheumatoid arthritis), its apparent effects on lipid profiles, and elsewhere reported inhibition of platelet aggregation and reduction in diabetes risk, along with its excellent safety profile and low cost, make it a beneficial first-line or an adjunct therapy for RA patients, particularly those with traditional cardiovascular disease risk factors.”

Reference:

Hydroxychloroquine use is associated with improvement in lipid profiles in rheumatoid arthritis patients

Arthritis Care Res 2010