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Hydroxychloroquine Improves Survival in Lupus

May 26, 2020 5:30 pm

Hydroxychloroquine (HCQ) has dominated the news in recent weeks, because of poor outcomes reported when used in COVID patients. Yet, a recent report reaffirms what rheumatologists have known for years - that HCQ use is associated with better outcomes in systemic lupus erythematosus (SLE), including survival.  

Jorge et al conducted a nested case‐control study with incident SLE patients from British Columbia, Canada and compared those deceased SLE cases with a control group of up to three living controls (matched by age, sex, and SLE disease duration).

Among 6,241 patients with incident SLE, we identified 290 deceased SLE cases and 502 matched SLE controls.

Current use of HCQ was associated with a 50% reduction in mortality (adjusted odd ratios for all‐cause mortality was 0.50; 95% CI: 0.30‐0.82).  The all cause mortality risk for those who stopped HCQ was increased (aOR 2.47; 95% CI: 1.21‐5.05).

The survival benefit associated with current HCQ use was evident regardless of SLE disease duration. The increased mortality among patients who had discontinued HCQ could be due to a sick stopper effect or the loss of HCQ survival benefit.

Disclosures
The author has no conflicts of interest to disclose related to this subject

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