Hydroxychloroquine protects SLE patients against CV events

Among patients with systemic lupus erythematosus (SLE), those who use of hydroxychloroquine are less likely to experience cardiovascular events, as reported in a study.

For the study, researchers used data from the National French Healthcare Database and applied a nested case–control design. The SLE cohort included 52,883 patients (mean age 44.23 years, 86.6 percent female, mean follow-up 9.01 years), including 1,981 patients with eligible CV events (case group) and 16,892 matched patients without CV (control group).

Hydroxychloroquine use within 365 days prior to the index date was defined as current (within 90 days), remote (91-365 days), or no exposure. CV events included myocardial infarction (MI), stroke, and other thromboembolic events.

A total of 49,597 patients (87.7 percent) received at least one hydroxychloroquine dispensation during follow-up. Compared with nonusers, current users of hydroxychloroquine were younger (mean age 55.48 vs 60.08 years), were less likely to have chronic kidney disease (7.6 percent vs 11.0 percent), had lower prevalence of acute nephritis (17.1 percent vs 19.1 percent) and cancer (8.0 percent vs 12.7 percent) but higher prevalence of diabetes (25.8 percent vs 18.2 percent) and antiphospholipid syndrome (9.1 percent vs 6.9 percent).

A total of 669 MI events, 916 stroke events, and 696 other thromboembolic events were documented. Multivariable conditional logistic regression showed that relative to no exposure, current exposure was associated with lower odds of composite CV events (odds ratio [OR], 0.63, 95 percent confidence interval [CI], 0.57–0.69) and of MI (OR, 0.72, 95 percent CI, 0.60–0.85), stroke (OR, 0.69, 95 percent CI, 0.60–0.81), and other thromboembolic events (OR, 0.58, 95 percent CI, 0.49–0.69).