Hydroxychloroquine shows potential survival benefit in systemic sclerosis

Systemic sclerosis (SSc) patients using hydroxychloroquine have reduced mortality, although they appear to have a higher prevalence of pulmonary hypertension compared with their peers who do not use the drug, according to a retrospective study.

Researchers used de-identified electronic medical records from the TriNetX Research network and looked at adults with an SSc diagnosis. They performed propensity score matching to establish a cohort of hydroxychloroquine users and nonusers.

Outcomes of interest including mortality, pulmonary hypertension, acute myocardial infarction (MI), cerebral infarction, conduction heart disease, and myocarditis were assessed in hydroxychloroquine users and nonusers over 5 years.

The analysis included 15,485 pairs of hydroxychloroquine users and nonusers. Over 5 years, hydroxychloroquine users had roughly 13-percent higher risk of pulmonary hypertension (risk ratio [RR], 1.124, 95 percent confidence interval [CI], 1.052–1.200; p<0.001) but around 28-percent lower risk of mortality (RR, 0.719, 95 percent CI, 0.674–0.767; p 0.001), indicating potential survival benefits.

No significant between-group differences were observed for the other outcomes, including ischaemic heart disease, myocardial infarction, cerebral infarction, conduction disorders, or myocarditis.

Additional prospective studies are needed to validate these findings and establish the role of hydroxychloroquine in SSc management.