Lupus & antiphospholipid syndrome
Association of Hydroxychloroquine Dose With Adverse Cardiac Events in Patients With Systemic Lupus Erythematosus
Authors' conclusion
Higher HCQ doses were not associated with an increased risk of HFrEF, life-threatening arrhythmia, or cardiac death among patients with SLE and may decrease the risk among nonsmokers.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) taking hydroxychloroquine (HCQ) with ≥1 echocardiogram, tertiary care center in the Bronx, New York, 2005–2021median follow-up 7.9 years
- Participants
- 294 patients
- Exposure
- HCQ weight-based dose at HCQ start, stratified by smoking status
- Nonsmokersn = 226
- Smokersn = 68
- Outcome
- Incident all-cause heart failure with reduced ejection fraction (HFrEF), life-threatening arrhythmia, or cardiac death
Methodological detailssingle tertiary care centre, Fine-Gray regression with death as competing event, stratified by smoking status, propensity score analysis (secondary)
- Single tertiary care centre
- Fine-Gray regression with death as competing event
- Stratified by smoking status
- Propensity score analysis (secondary)
Main finding
As reported in the abstract
HFrEF, life-threatening arrhythmia or cardiac death, per higher HCQ weight-based dose
Estimate (CI)P value
Nonsmokersinterval printed as IQR; adjusted for age, BMI, hypertension, CKD, diabetes mellitus, thromboembolism
subdistribution HR 0.62(0.41–0.92)
P = 0.02Smokersinterval printed as IQR
subdistribution HR 0.85 per mg/kg(0.53–1.34)
P = 0.48Each row per its own increment, as printed
- Developed the outcome (all patients)
- 37 (13%)
Observational data: associations, not effects.
Further findings
Propensity score analysis (secondary analysis)
- Propensity score analysis showed comparable results
Original publication
Association of Hydroxychloroquine Dose With Adverse Cardiac Events in Patients With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). Published 3 February 2023. doi:10.
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