Associations of Hydroxychloroquine Use With Lipid Profiles in Rheumatoid Arthritis: Pharmacologic Implications

Abstract

Results. In an elderly, predominantly male VARA cohort, 1,011 patients had lipid profiles; 787 patients (77.8%) were white. Statin use was recorded in 11.6% of patients, diabetes mellitus in 33.5%, and CVD in 31.2%. HCQ users (n ‫؍‬ 150) were older, had longer rheumatoid arthritis (RA) disease duration, and had lower disease activity. Optimum lipid profiles, including total cholesterol:high-density lipoprotein (HDL) and HDL:low-density lipoprotein ratios (P < 0.001), were more frequent in HCQ users, with the exception of HDL (P ‫؍‬ 0.165), and persisted in multivariate analyses. Similarly, more HCQ users had NCEP-ATP III target levels. Varied periods of HCQ exposure suggested lipid changes to occur early, but lost within a year of drug discontinuation. HCQ users had less prevalent CVD. Conclusion. In RA patients, HCQ use of at least 3 months' duration was associated with better lipid profiles irrespective of disease activity or statin use. Given the increased CVD risks in RA and the relative low cost and toxicity of HCQ, continued use, regardless of treatment regimen, should be considered.

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

“…This could be the reason for the underestimation of the prevalence. Another reason could be that a larger proportion of the patients was on hydroxychloroquine, which has a cholesterol-lowering effect (30 (33). As expected, the likelihood of hypercholesterolemia was higher in smokers (OR: 1.877).…”

Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications

“…CHF=congestive heart failure; COX=cyclooxygenase; CVD=cardiovascular disease; DMARDs=disease modifying anti-rheumatic drugs; HCQ=hydroxychloroquine; LDL=low density lipoprotein; MI=myocardial infarction; NSAID=non-steroidal anti-inflammatory drug; RA=rheumatoid arthritis; RR=relative risk; TNF=tumor necrosis factor1790949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127…”

Dislipidemia y riesgo aterogénico en pacientes con artritis reumatoide

“…Curtis et al 14 encontraron en población estadounidense con AR una frecuencia de DLP del 49,3%, medias de triglicéridos de 133,1 mg/dl, c-LDL de 113,1 mg/dl, c-HDL de 56,6 mg/dl y un índice aterogénico de Castellí 3,8; esta menor frecuencia y mejor perfil lipídico comparado con el encontrado en nuestra población podrían deberse al efecto farmacológico, ya que la población estudiada por Curtis et al 14 empleó menor frecuencia de glucocorticoides, emplearon anti-TNF, así como estatinas. Kerr et al 33 estudiaron el mismo tipo de población que Curtis et al 14 y encontraron menores niveles de triglicéridos (140,3 mg/dl) y c-LDL (105,9 mg/dl) comparados con nuestros resultados; esto puede deberse a que esta población estudiada presentaba menores frecuencias de empleo de glucocorticoides y menor IMC, así como menores niveles de PCR.…”