Hydroxychloroquine (Plaquenil) may delay onset of SLE

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Hydroxychloroquine may delay onset of SLE

New Orleans, LA - It's been thought for some time that the antimalarial drug

hydroxychloroquine (Plaquenil®, Sanofi-Synthelabo) may delay the onset of

systemic lupus erythematosus, and in fact rheumatologists already use the

drug for this purposeprobably more than would care to admit it, says Dr

Judith (Oklahoma Medical Research Foundation, Oklahoma City). But hard

evidence to support this has been lacking, until now.

At the American College of Rheumatology meeting, and colleagues

presented data from a retrospective study, based on serum samples taken from

military personnel, suggesting that giving the drug on first appearance of

clinical symptoms significantly delays the onset of full-blown disease.

The study used material from the US Army-Navy Serum Repository, which stores

more than 30 000 000 serum samples from active-duty military personnel. The

blood samples are taken on entry to the service and then about every 2

years. A scan found 130 individuals who had been diagnosed with SLE and also

had at least 1 serum sample taken before diagnosis. Of these, 26 patients

had used hydroxychloroquine before the diagnosis.

Statistical analysis showed that the patients who had taken

hydroxychloroquine before diagnosis had a statistically significant increase

(Kruskal-Wallis test, p=0.0006) in the lag time between the onset of first

clinical symptoms and the development of 4-criteria SLE compared with

patients not treated with hydroxychloroquine before diagnosis (median lag

times of 1.08 years vs 0.42 years, respectively). A further analysis of

these serum samples was carried out for nonsteroidal anti-inflammatory drugs

(NSAIDs), but this showed no difference between those taking and those not

taking these drugs.

These findings suggest that hydroxychloroquine may significantly delay the

onset of SLE, the researchers concluded. added that this is the first

time this has been shown but emphasized that the data are preliminary. The

group now hopes to confirm the findings using a third cohort of patients,

and ideally, says it would be good to carry out a prospective study in

patients who are at risk of developing SLE.