A favorable effect of hydroxychloroquine on glucose and lipid metabolism beyond its anti-inflammatory role

Abstract

Hydroxychloroquine (HCQ), a commonly used antimalarial drug in rheumatic diseases, has shown favorable metabolic effects on both glucose control and lipid profiles. We describe a case of a young woman with type 1 diabetes whose glycemic control was optimized with the introduction of HCQ as a treatment for her Sjogren syndrome in addition to a subtle yet measurable improvement in her lipid profile. An increasing body of evidence supports the beneficial impacts of HCQ in various ancillary conditions, including diabetes mellitus and dyslipidemia. However, mechanisms of action responsible for these effects remain ill-defined and may include alterations in insulin metabolism and signaling through cellular receptors. These favorable metabolic effects of HCQ and further understanding of underlying mechanisms may provide an additional rational for its use in rheumatic diseases, conditions associated with an elevated cardiovascular risk.

Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study

“…As expected, the likelihood of hypercholesterolemia was higher in smokers (OR: 1.877). Decrease in likelihood of hypercholesterolemia with increase in age noted in the current study could be due to hydroxychloroquine therapy (34)(35)(36)(37). Moreover, these patients had decreased likelihood of hypercholesterolemia with increase in DOIP, suggesting that the reduction in hypercholesterolemia may be because of less severe RA.…”

EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update

“…In contrast, the use of antimalarials, such as hydroxychloroquine and chloroquine, is still substantial, especially in combination therapy122 or as monotherapy in patients with very mild disease,138 particularly in China. Interestingly, antimalarials may have significant positive effects on lipid and glucose metabolism139 and may reduce cardiovascular risk in RA 140. However, joint damage is not retarded to a similar extent as with other csDMARDs 141.…”

Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases

“…A more recent study of glycaemic control in women with RA or SLE demonstrated that patients treated with HCQ had lower fasting glucose levels than those not receiving HCQ (Hage et al 2014), leading to the conclusion that HCQ may be beneficial in reducing the risk of cardiovascular disease which is known to be a significant factor contributing to premature mortality in these patients (Penn et al 2010).…”