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Hydroxychloroquine can reduce risk of organ damage in patients with lupus

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects every organ system in the body. Individuals with the disease typically suffer from periodic episodes of inflammation and damage to joints, connective tissues, and organs. Certain medications to treat the disease can also lead to damage ranging from heart attacks to strokes. One of the more commonly prescribed medications for lupus in the United States is hydroxychloroquine (HCQ), an antimalarial drug that appears to reduce the risk of new damage in patients who have not yet developed damage when they begin HCQ treatment, according to a new study.

With partial support from the Agency for Healthcare Research and Quality (HS10389), researchers at the Center for Education and Research on Therapeutics at the University of Alabama and colleagues examined the outcomes of lupus patients who had the disease for 5 years or less. They measured the patients' demographic characteristics, clinical and serological manifestations of the disease, as well as disease activity (by the Systemic Lupus Activity Measure, SLAM), and damage (by the Systemic Lupus International Collaborating Clinics damage index, SDI).

Patients who were not treated with HCQ on enrollment (44 percent) had higher SLAM and SDI scores than patients who were treated (56 percent), and they were significantly more likely to have major organ involvement such as renal disease or central nervous system disease. Even after adjustment for factors that influence lupus activity and/or damage accrual, HCQ usage was still associated with 27 percent reduced risk of developing new damage. Patients receiving HCQ who had no damage at study entry had a 45 percent decrease in the risk of damage accrual. HCQ did not decrease the risk of damage for those who already had damage at study entry.

More details are in "Systemic lupus erythematosus in three ethnic groups," by Barri J. Fessler, M.D., Graciela S. Alarcon, M.D., M.P.H., Gerald McGwin Jr., Ph.D., M.S., and others, in the May 2005 Arthritis & Rheumatism 52(5), pp. 1473-1480.

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