RESEARCH - Hydroxychloroquine and glycemia in women with RA and SLE

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J Rheumatol. 2010 May 1.

Hydroxychloroquine and Glycemia in Women with Rheumatoid Arthritis and

Systemic Lupus Erythematosus.

Penn SK, Kao AH, Schott LL, Elliott JR, Toledo FG, Kuller L, Manzi S, Wasko MC.

From the Department of Medicine, Division of Rheumatology, and

Division of Endocrinology; Department of Epidemiology, Graduate School

of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania,

USA.

Abstract

OBJECTIVE: To determine the relationship between current

hydroxychloroquine (HCQ) use and 2 indicators of glycemic control,

fasting glucose and insulin sensitivity, in nondiabetic women with

systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA).

METHODS: Nondiabetic women with SLE (n = 149) or RA(n = 177) recruited

between 2000 and 2005 for a cross-sectional evaluation of

cardiovascular risk factors were characterized by HCQ usage status.

Unadjusted and multivariately adjusted mean fasting glucose, median

insulin, and insulin resistance [assessed by the homeostasis model

assessment (HOMA-IR) calculation] were compared among HCQ users and

nonusers for disease-specific groups.

RESULTS: More women with SLE were taking HCQ than those with RA (48%

vs 18%; p < 0.0001; mean dose ~ 400 mg vs ~ 200 mg). For women with

SLE or RA, after adjustment for age, waist circumference, disease

duration, prednisone dosage, C-reactive protein, menopausal status,

nonsteroidal antiinflammatory drugs, and disease-specific indicators,

serum glucose was lower in HCQ users than in nonusers (SLE: 85.9 vs

89.3 mg/dl, p = 0.04; RA: 82.5 vs 86.6 mg/dl, p = 0.05). In women with

SLE, HCQ use also was associated with lower (log)HOMA-IR (0.97 vs

1.12, p = 0.09); in those with RA, no differences in (log)HOMA-IR were

seen. HCQ usage was not associated with fasting insulin levels in

either patient group.

CONCLUSION: HCQ use was associated with lower fasting glucose in women

with SLE or RA and also lower (log)HOMA-IR in the SLE group. The use

of HCQ may be beneficial for reducing cardiovascular risk by improving

glycemic control in these patients.

PMID: 20436082

http://www.ncbi.nlm.nih.gov/pubmed/20436082

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