Efficacy analysis of hydroxychloroquine therapy in systemic lupus erythematosus: a study on disease activity and immunological biomarkers

Monzavi, Seyed Mostafa; Alirezaei, Aida; Sarabi, Zhaleh Shariati; Afshari, Jalil Tavakol; Mahmoudi, Mahmoud; Dormanesh, Banafsheh; Jahandoost, Faezeh; Khoshdel, Alireza; Rezaie, Ali

doi:10.1007/s10787-018-0512-y

Cited by 26 publications

(21 citation statements)

References 47 publications

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“…Serum IL-6 levels between active and inactive SLE patients were compared in 9 studies (24)(25)(26)29,31,39,(41)(42)(43). Additionally, the correlation coefficient between serum IL-6 level and SLE disease activity was reported in 13 studies (24)(25)(26)(29)(30)(31)(35)(36)(37)(38)(39)44,45). Among all included studies, 3 studies focused on children with SLE (25,28,46), and 21 studies focused on adults with SLE (23,24,26,27,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45).…”

Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis

Ding¹,

Su²,

You³

et al. 2020

Clinics

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Interleukin-6 (IL-6) plays a crucial role in systemic autoimmunity and pathologic inflammation. Numerous studies have explored serum IL-6 levels in systemic lupus erythematosus (SLE) and their correlation with disease activity. Here, we performed a meta-analysis to quantitatively assess the correlation between the serum IL-6 levels and SLE activity. The PubMed and EMBASE databases were thoroughly searched for relevant studies up to September 2019. Standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were used to describe the differences between serum IL-6 levels in SLE patients and healthy controls and between those in active SLE patients and inactive SLE patients. The correlation between the serum IL-6 levels and disease activity was evaluated using Fisher's z values. A total of 24 studies involving 1817 SLE patients and 874 healthy controls were included in this meta-analysis. Serum IL-6 levels were significantly higher in SLE patients than in the healthy controls (pooled SMD: 2.12, 95% CI: 1.21-3.03, Active SLE patients had higher serum IL-6 levels than inactive SLE patients (pooled SMD: 2.12, 95% CI: 1.21-3.03). Furthermore, the pooled Fisher's z values (pooled Fisher's z=0.36, 95% CI: 0.26-0.46, po0.01) showed that there was a positive correlation between the serum IL-6 levels and SLE activity. This study suggested that serum IL-6 levels were higher in patients with SLE than in healthy controls, and they were positively correlated with disease activity when Systemic Lupus Erythematosus Disease Activity Index44 was defined as active SLE. More homogeneous studies with large sample sizes are warranted to confirm our findings due to several limitations in our meta-analysis.

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Section: Characteristics Of Eligible Studiesmentioning

confidence: 99%

Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis

Ding¹,

Su²,

You³

et al. 2020

Clinics

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“…Chloroquines which are originally antimalarial drugs are now being widely used in the treatment of autoimmune diseases [1,2]. Also, they are used as emerging treatment options for skin, oncologic, and pediatric inflammatory disorders [3].…”

Section: Introductionmentioning

confidence: 99%

Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

2020

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Purpose To detect the early changes in retinal vasculature via optical coherence tomography angiography (OCTA) by comparing the quantitative OCTA parameters in the group of patients who were using hydroxychloroquine (HCQ) or not. Methods This was a cross-sectional, comparative, and observational study. The patients who were newly or previously prescribed HCQ for an autoimmune disease were included. OCTA imaging was performed via OCT RT XR Avanti with AngioVue software (Optivue Inc, Freemont, CA). The study group had two groups: a control group (patients newly diagnosed and who were not taking any medication) and a treatment group (patients who were receiving HCQ treatment). The main outcome measure was OCTA parameters. Results A total of 102 eyes of 102 patients were included. There were 70 patients in the treatment group and 32 patients in the control group. All of the vascular density values were similar between the control and treatment groups (p [ 0.05 for all). However, the superficial whole thickness, superficial parafoveal thickness, superficial perifoveal thickness, deep whole thickness, deep parafoveal thickness, and deep perifoveal thickness were thinner in the treatment group than the control group (p \ 0.05 for all). Conclusion Vascular density parameters did not differ between the control and treatment groups. However, the retinal thickness values were lower in the treatment group.

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“…CQ decreases the concentrations of IL-6, IL-1β and TNF-α in several immune cells (Jang et al 2006). Another study yielded similar results with SLE patients treated with HCQ finding that the concentrations of IL-6, IL-1β and TNF-α were elevated prior to treatment, and reduced after two months of treatment (Monzavi et al 2018). Several additional studies have demonstrated that HCQ decreases elevated IL-6 concentrations in RA and SLE patients (da Silva et al 2013;Batún-Garrido et al 2018) and in an animal model of neuroinflammation (Koch et al 2015).…”

Section: Approved Mediations That Reduce Cytokines Involved In the Csmentioning

confidence: 67%

The treatment of SARS-CoV2 with antivirals and mitigation of the cytokine storm syndrome: the role of gene expression

Luo

Ige

Beacon

et al. 2021

Genome

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In the absence of a vaccine, the treatment of SARS-CoV2 has focused on eliminating the virus with antivirals or mitigating the cytokine storm syndrome (CSS) that leads to the most common cause of death: respiratory failure. Herein we discuss the mechanisms of antiviral treatments for SARS-CoV2 and treatment strategies for the CSS. Antivirals that have shown in vitro activity against SARS-CoV2 or the closely related SARS-CoV1 and MERS-CoV, are compared on the enzymatic level and by potency in cells. For treatment of the CSS we discuss medications that reduce the effects, or expression of cytokines involved in the CSS with an emphasis on those that reduce IL-6 because of its central role in the development of the CSS. We show that some of the medications covered influence the activity or expression of enzymes involved in epigenetic processes and specifically those that add or remove modifications to histones or DNA. Where available, the latest clinical data showing the efficacy of the medications is presented. With respect to their mechanisms, we explain why some medications are successful, why others have failed, and why some untested medications may yet prove useful.

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Efficacy analysis of hydroxychloroquine therapy in systemic lupus erythematosus: a study on disease activity and immunological biomarkers

Abstract: HCQ therapy is effective on clinical improvement of SLE patients through interfering with inflammatory signaling pathways, reducing anti-DNA autoantibodies and normalizing the complement activity.

Cited by 26 publications

References 47 publications

Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis

Serum interleukin-6 level is correlated with the disease activity of systemic lupus erythematosus: a meta-analysis

Is optical coherence tomography angiography a useful tool in the screening of hydroxychloroquine retinopathy?

The treatment of SARS-CoV2 with antivirals and mitigation of the cytokine storm syndrome: the role of gene expression

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