Efficacy and safety of hydroxychloroquine in the treatment of type 2 diabetes mellitus: a double blind, randomized comparison with pioglitazone

Pareek, Anil; Chandurkar, Nitin; Nicolaï, Thomas; Viswanathan, Vijay; Deshpande, Alaka; Gupta, Ojas; Shah, Asha; Kakrani, Arjun; Bhandari, Sudhir; Thulasidharan, NK; Saboo, Banshi; Devaramani, Shashidhar; Vijaykumar, Nagalakshmi; Sharma, Shrikant; Agrawal, Navneet; Mahadevaiah, Mahesh; Kothari, Kunal

doi:10.1185/03007995.2014.909393

Cited by 89 publications

(77 citation statements)

References 24 publications

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“…There was a significant reduction in the mean HbA1c, FBG and PPG from baseline at week 24 in both the groups. 8 A marginal weight reduction of 1.08 kg was also reported with hydroxychloroquine in that study. All the trials till now conducted with Hydroxychloroquine 400mg has confirmed its superior potency of HbA1c reduction in uncontrolled T2DM patients.…”

supporting

confidence: 53%

“…A double-blinded, randomized study of 267 patients with uncontrolled T2DM was conducted by Pareek et al 8 That study conclusively showed that hydroxychloroquine had a similar anti-hyperglycaemic effect as pioglitazone among the patients refractory to metformin and sulfonylurea treatment. Based on this study, hydroxychloroquine 400mg has been officially approved by drug regulatory authority of India to improve glycemic control of T2DM patients on metformin, sulfonylurea combination as an adjunct to diet and exercise therapy.…”

mentioning

confidence: 99%

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Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

Baidya¹,

Ahmed

2018

Int J Res Med Sci

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Background: Present study assessed the effect of early addition of hydroxychloroquine to metformin and sulfonylurea in inadequately controlled T2DM patients as compared to up titration of the metformin or sulfonylurea (glimepiride) doses.Methods: Patients with glycated haemoglobin (HbA1c) between ≥7.0 to ≤9.0% and on metformin 1000mg/day and glimepiride 2mg/day for at least 12 weeks were analysed for this study. Patients were randomized into three groups, in one group (n=55) metformin dose was up titrated to 2000mg daily and in second group (n=55) hydroxychloroquine (HCQ) 400mg was added along with other and in third group (n=55) glimepiride dose was up titrated to 4mg. Fasting plasma glucose (FPG), post prandial plasma glucose (PPG) and glycated haemoglobin (HbA1c) were measured at baseline and after 12 and 24 weeks. Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and Triglyceride were measured at baseline and after 6 months. Authors have analysed the data of 150 patients as rest were either lost in follow up or discontinue therapy.Results: After 24 weeks, the mean HbA1c was 6.5% in hydroxychloroquine group (p<0.001) versus 6.8% in metformin 2000mg group (p<0.001) and 6.7% in glimepiride 4mg group (p<0.001). There was also a modest reduction in lipid parameters (p<0.001) with no change in serum creatinine level and a marginal reduction in body weight in the HCQ group. Incidence of confirmed hypoglycemia was significantly lower in patients of HCQ group compared to glimepiride group in this study.Conclusions: Hydroxychloroquine as add on to metformin and glimepiride combination during the early course of treatment helps in achieving glycaemic target and can consider as an option rather up titrating the dose of metformin or glimepiride.

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supporting

confidence: 53%

mentioning

confidence: 99%

Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

Baidya¹,

Ahmed

2018

Int J Res Med Sci

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show abstract

“…A double-blinded, randomized study of 267 patients with uncontrolled T2DM was conducted by Pareek et al [10] in 2014 in India. This study conclusively showed that hydroxychloroquine had a similar anti-hyperglycaemic effect as pioglitazone among the patients refractory to metformin and sulfonylurea treatment.…”

Section: Discussionmentioning

confidence: 99%

Improvement of type 2 diabetes mellitus control with hydroxychloroquine added to triple oral antidiabetis drugs: a case report

Satpathy¹,

Purkait²,

Talware³

2018

Clinical Diabetology

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“…22 ( Table 1). Another RCT by Gerstein et al on 135 patients with T2DM resistant to sulfonylureas showed significant reduction of HbA1c (-0.96%) with 18 months of HCQ without significant improvement in insulin resistance.…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

“…Mechanisms responsible for altered lipid profiles with chloroquine analogue treatment include a significant increase in lipid clearance rate and up-regulation of LDL receptors. 6,8,10,11,20,22 In this context chloroquine is effective as both hypolipidaemic and antidiabetic drug.…”

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confidence: 99%

Efficacy of hydroxychloroquine as a potential antidiabetic drug

Kumar

Kamath

Reddy

2017

Int J Basic Clin Pharmacol

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Background: India is the world’s diabetic capital. Oral antidiabetic therapy is still incomplete. Prior studies have shown that hydroxychloroquine (HCQ), a commonly used antimalarial, anti-rheumatic drug reduces the risk of developing diabetes mellitus. It probably acts by decreasing insulin metabolism- a novel mechanism of action.Methods: A systematic search was done in MEDLINE database with key words ‘Type 2 Diabetes Mellitus’, ‘Hydroxychloroquine’. Articles assessing the antidiabetic efficacy of hydroxychloroquine were reviewed and their results summarized.Results: With extensive literature search, we found out three RCTs and four Cohort studies assessing the efficacy of HCQ on glycaemic markers in patients with type 2 diabetes mellitus. Two randomized controlled trials done by Gerstein H C et al, Pareek A et al, comparing hydroxychloroquine with established antidiabetic drugs showed that there is significant reduction in glycaemic parameters with comparable similarity in both the groups (HbA1c: -0.91%±0.4%). Solomon et al in their study on patients with RA concluded that HCQ improved insulin sensitivity. Two cohort studies by Chen Y M et al and Wasko MCM et al respectively showed reduced incidence of diabetes mellitus in Systemic lupus erythematosus (Hazard ratio=0.26) and rheumatologic disease (relative risk=0.23) patients who received hydroxychloroquine. In a cohort study by Rekedal LR et al, HCQ reduced HbA1c by 0.66% compared to baseline in patients with RA. These studies also showed that hydroxychloroquine has favourable effect on lipid profile and good tolerabilityConclusions: Hydroxychloroquine has a potential to enter antidiabetic armamentarium due to its efficacy and low toxicity profile. More studies are required to confirm this.

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Efficacy and safety of hydroxychloroquine in the treatment of type 2 diabetes mellitus: a double blind, randomized comparison with pioglitazone

Cited by 89 publications

References 24 publications

Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

Improvement of type 2 diabetes mellitus control with hydroxychloroquine added to triple oral antidiabetis drugs: a case report

Efficacy of hydroxychloroquine as a potential antidiabetic drug

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