Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients

Morris, Stephanie J.; Wasko, Mary Chester; Antohe, Jana L.; Sartorius, Jennifer; Kirchner, H. Lester; Dancea, Sorina; Bili, Androniki

doi:10.1002/acr.20393

Cited by 136 publications

(90 citation statements)

References 16 publications

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“…The added lipidlowering benefit of HCQ in rheumatic diseases is well documented (32,33), including in RA (19). Our findings were similar; HCQ had independent associations with lower lipid values, save for the nonsignificant elevation of HDL.…”

Section: Discussionsupporting

confidence: 80%

“…Hydroxychloroquine (HCQ) is often used in combination with other traditional disease-modifying antirheumatic drug (DMARD) treatment regimens and is reported to lower atherogenic lipids in systemic lupus erythematosus as well as in RA (17)(18)(19). However, HCQ is often discontinued once biologic agents are commenced in RA treatment regimens (20).…”

Section: Introductionmentioning

confidence: 99%

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

Kerr

Aujero

Richards

et al. 2014

Arthritis Care & Research

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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.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

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

Kerr

Aujero

Richards

et al. 2014

Arthritis Care & Research

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“…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.…”

Section: N Discussion and Conclusionmentioning

confidence: 72%

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

Chandrashekara

Shobha

Dharmanand³

et al. 2017

Reumatismo

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SUMMARYThe aim was to study the prevalence of comorbidities in rheumatoid arthritis (RA) patients in everyday clinical practice and their association with disease-specific and demographic factors. The multi-center study recruited 3,247 (at 14 centers, and 265) were excluded due to incomplete data. The number of subjects considered for the analysis was 2982. The mean (±standard deviation) age was 48.98±12.64 years and the male-to-female ratio was 1:5. The data was collected based on a pre-structured pro forma by trained clinical research associates through interview and verification of charts and reports available in the patient records. The following comorbidities were studied: cardiovascular disease, hypertension, diabetes mellitus, hypercholesterolemia, thyroid disease, psychiatric diseases like depression, and pulmonary disease. Hypertension (20.7%), diabetes mellitus (14.4%) and thyroid disease (18.3%) were the most prevalent comorbidities. Hypercholesterolemia (5.3%), pulmonary diseases (2.1%), cardiovascular diseases (0.2%) and depression (0.03%) were prevalent in ≤5% of the study population. The overall presence of comorbidity increased with age and reduced with the duration of illness prior (DOIP). The age, gender, and DOIP differed significantly between groups with and without hypercholesterolemia. Females had a statistically increased prevalence of thyroid disease. The prevalence of comorbidities in RA patients from south India is around 40% and the incidence of comorbidity increased with age. As per the literature evidence, the prevalence in the current study subjects was higher when compared to prevalence of similar diseases occurring in the general south Indian population.

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“…Hence the increase in HDL cholesterol levels in RA patients undergoing treatment in the present study can be explained as an effect of treatment in these patients. Morris et al [31] studied the effect of HCQ and reported that the use of HCQ in the RA cohort was independently associated with a significant decrease in LDL-C, TC, LDL-C/HDL-C, and TC/HDL-C.…”

Section: Effect Of Dmards On Lipid Parametersmentioning

confidence: 99%

Serum Lipid Alterations in Early Rheumatoid Arthritis Patients on Disease Modifying Anti Rheumatoid Therapy

et al. 2016

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Dyslipidaemia is a major CVD risk factor in the general population. Current evidence suggests that lipid metabolism is altered in RA due to inflammation, and that use of anti-inflammatory therapy may reverse some of these changes. The objective of our study is to compare the effect of treatment with DMARD on lipid fractions after 6 months of therapy. Forty patients who met the American College of Rheumatology, ACR/EULAR criteria for rheumatoid arthritis, with disease duration of less than 1 year and no prior treatment were included in the study. Thirty healthy volunteers were included as controls. The mean DAS-28 at disease onset was 5.15 ± 1.3. Early Rheumatoid Arthritis (ERA) patients exhibited higher serum levels of total cholesterol (TC) and lowdensity lipoprotein cholesterol (LDL-C) and lower serum highdensity lipoprotein cholesterol (HDL-C) levels compared to controls. As a consequence, the atherogenic index of plasma [log (TG/HDL-C)], the atherogenic indices: TC/ HDL-C as well as LDLC/HDL-C was significantly higher in ERA patients compared to controls. After 6 months of treatment, there was significant reduction of the DAS 28, HDL-C and Apo A-I improved and Lp(a) decreased significantly. All lipid ratios improved, a phenomenon primarily due to the increase in serum HDL-C levels. These changes were inversely correlated with CRP and ESR. In conclusion, ERA patients are characterized by an atherogenic lipid profile, which improves with DMARD therapy.

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Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients

Cited by 136 publications

References 16 publications

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

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

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

Serum Lipid Alterations in Early Rheumatoid Arthritis Patients on Disease Modifying Anti Rheumatoid Therapy

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