Hydroxychloroquine reduces MACE risk in patients with lupus erythematosus

Use of hydroxychloroquine (HCQ) is inversely associated with the risk of cardiovascular events in patients with lupus erythematosus (LE), as indicated by the results of a recent study.

This observational cohort study used Danish nationwide registers to determine whether HCQ treatment correlated with major adverse cardiovascular events (MACE; ie, myocardial infarction, ischaemic stroke, or cardiovascular-associated death) in patients with first-time diagnosis of cutaneous or systemic LE between 1997 and 2017.

Cox regression models were used to calculate the hazard ratio (HR) for the risk of MACE and to compare time on and off HCQ, including never users. The authors adjusted the models for age, sex, socioeconomic status, concomitant treatment, and cardiovascular risk factors.

A total of 4,587 patients with LE were identified, of whom 2,343 (51 percent) were treated with HCQ during the study period. An inverse association was observed between use of HCQ and MACE risk among patients with systemic LE (adjusted HR, 0.65, 95 percent confidence interval [CI], 0.46–0.90) and those with cutaneous LE (adjusted HR, 0.71, 95 percent CI, 0.42–1.19).

Sensitivity analyses including a case-time control design revealed consistent results.

“Our findings indicate an opportunity to reduce the risk of cardiovascular events in patients with LE through use of HCQ,” the authors said.

One limitation of this study was the lack of information on disease activity or severity.