Hydroxychloroquine in systemic lupus erythematosus: results of a French multicentre controlled trial (PLUS Study)

Costédoat-Chalumeau, Nathalie; Galicier, Lionel; Aumaître, O.; Françès, Camille; Guern, Véronique Le; Lioté, Frédéric; Смаил, А.; Limal, Nicolas; Pérard, L.; Desmurs‐Clavel, H.; Boutin, D.; Asli, Bouchra; Kahn, Jean‐Emmanuel; Pourrat, Jacques; Sailler, L.; Ackermann, Félix; Papo, Thomas; Sacré, Karim; Fain, Olivier; Stirnemann, Jérôme; Cacoub, Patrice; Jallouli, M.; Leroux, Gaëlle; Cohen-Bittan, Judith; Tanguy, Marie‐Laure; Hulot, Jean‐Sébastien; Lechat, Philippe; Musset, Lucile; Amoura, Zahir; Piette, Jean‐Charles

doi:10.1136/annrheumdis-2012-202322

Cited by 176 publications

(154 citation statements)

References 21 publications

(23 reference statements)

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“…Its efficacy in treating mucocutaneous disease along with fatigue and serositis has been widely demonstrated 2,3 . HCQ is used mainly in the treatment of mild SLE, with strong evidence showing significant reductions in mortality, disease activity, flare rate, and the chance of renal disease 4,5 . It is one of the few drugs licensed for SLE and the most common antimalarial drug prescribed for the condition.…”

Section: Increased Incidence Of Gastrointestinal Side Effects In Patimentioning

confidence: 99%

Increased Incidence of Gastrointestinal Side Effects in Patients Taking Hydroxychloroquine: A Brand-related Issue?

2017

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Section: Increased Incidence Of Gastrointestinal Side Effects In Patimentioning

confidence: 99%

Increased Incidence of Gastrointestinal Side Effects in Patients Taking Hydroxychloroquine: A Brand-related Issue?

2017

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“…Several studies have shown the usefulness of measurements of HCQ levels in particular in patients with SLE [97][98][99][100][101].…”

Section: Pharmacokinetics and Pharmacodynamics Of Antimalarials: Can mentioning

confidence: 99%

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

Piscianz

Cuzzoni

Sharma

et al. 2018

CMC

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The story of antimalarials as antinflammatory drugs dates back few centuries. Chinin, the extract of the Cinchona bark, has been exploited since the 18th century for its antimalarial and antifebrile properties. Later, during the Second World War, the broad use of antimalarials allowed arguing their antirheumatic effect on soldiers. Since then, these drugs have been broadly used to treat Systemic Lupus Erythematosus, but, only recently, the molecular mechanisms of action have been partly clarified.The inhibitory action on vacuole function and trafficking has been considered for decades the main mechanism of the action of antimalarials, affecting the activation of phagocytes and dendritic cells. In addition, chloroquine is also as a potent inhibitor of autophagy, providing another possible explanation of its antinflammatory action. However, much attention has been recently devoted to the action of antimalarials on the so-called cGAS-STING pathway deputed to the sensing of nucleic acid and to the production of type 1 interferons. This pathway is a fundamental mechanism for host defence, since it is able to detect microbial DNA and RNA and induce the immune response that will lead to the production of interferons. Of note, genetic defects in disposal of nucleic acids lead to inappropriate activation of the cGAS-STING pathway and inflammation. These disorders, named type I interferonopathies, represent a valuable model to study the antinflammatory potential of antimalarials.We will discuss possible development of antimalarials to improve the treatment of type I interferonopathies and, likely multifactorial disorders characterised by interferon inflammation, such as systemic lupus erythematosus.

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“…In such cases, correcting only [HCQ] could be insufficient. Thus, this negative result can probably be explained -at least partially -by nonadherence issues 8 .…”

Section: Routine Hydroxychloroquine Blood Concentration Measurement Imentioning

confidence: 99%

“…A French randomized, double-blinded, placebo-controlled, multicenter trial that included 573 patients with SLE (Plaquenil LUpus Systemic: PLUS study) was set up to answer this question 8 . However, even if this study confirmed the PK-PD relationship, we did not confirm the importance of adapting the daily HCQ dose to its blood level in terms of efficacy because patients in the "adaptation" group had the same probability of flare as those with stable daily dose.…”

Section: Routine Hydroxychloroquine Blood Concentration Measurement Imentioning

confidence: 99%

Routine Hydroxychloroquine Blood Concentration Measurement in Systemic Lupus Erythematosus Reaches Adulthood

Costédoat-Chalumeau

Guern

Piette³

2015

J Rheumatol

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Hydroxychloroquine in systemic lupus erythematosus: results of a French multicentre controlled trial (PLUS Study)

Abstract: Although low [HCQ] is associated with higher SLE activity, adapting the HCQ dose did not reduce SLE flares over a 7-month follow-up.

Cited by 176 publications

References 21 publications

Increased Incidence of Gastrointestinal Side Effects in Patients Taking Hydroxychloroquine: A Brand-related Issue?

Increased Incidence of Gastrointestinal Side Effects in Patients Taking Hydroxychloroquine: A Brand-related Issue?

Reappraisal of Antimalarials in Interferonopathies: New Perspectives for Old Drugs

Routine Hydroxychloroquine Blood Concentration Measurement in Systemic Lupus Erythematosus Reaches Adulthood

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