SLE rash treatment better with GC plus hydroxychloroquine combo vs GC monotherapy

Combination treatment with glucocorticoid (GC) plus hydroxychloroquine appears to yield more favourable outcomes than GC alone in the treatment of systemic lupus erythematosus (SLE) rash, while having a good safety profile, according to a study.

For the study, researchers performed a systematic review and meta-analysis of studies wherein the efficacy and safety of GC combined with hydroxychloroquine in the treatment of SLE rash were evaluated.

Multiple online databases were searched for relevant literature. The main outcome indicators were clinical total effective rate, adverse reactions, SLE disease activity index (SLEDAI) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complement 3 (C3).

A total of 11 studies involving 809 patients (406 in the test group and 403 in the control group) met the eligibility criteria and were included in the meta-analysis. Pooled data showed that compared with the single use of GC monotherapy, combination treatment with GC plus hydroxychloroquine led to improvements in clinical total effective rate in the treatment of SLE rash (odds ratio [OR], 4.27, 95 percent confidence interval [CI], 2.50–7.30; p<0.00001), as well as a decline in the occurrence of adverse reactions (OR, 0.26, 95 percent CI, 0.15–0.44; p<0.00001).

Moreover, combination therapy led to significantly greater reductions in SLEDAI score (mean difference [MD], 1.88, 95 percent CI, 1.66–2.10; p<0.00001), ESR level (MD, 7.92, 95 percent CI, 5.66–10.19; p<0.00001), and CRP level (MD, 3.22, 95 percent CI, 2.87–3.58; p<0.00001), as well as a significantly greater increase in C3 level (MD, 0.36, 95 percent CI, 0.32–0.41; p<0.00001).

Researchers advised caution when interpreting the findings due to the relatively small number of high-quality studies included in the meta-analysis. More high-quality, multicentre randomized controlled trials are needed to verify the present data.