Hydroxychloroquine and Risk of Long QT Syndrome in Rheumatoid Arthritis: A Veterans Cohort Study With Nineteen‐Year Follow‐up
Authors' conclusion
Hydroxychloroquine use had no association with LQTS during the first 2 years after initiation of therapy. There was a higher risk thereafter that became significant after 5 years of therapy. However, the 5-year absolute risk was very low, and the absolute risk difference was even lower. Both risks attenuated during longer follow-up.
Study context
- Population
- Veterans with newly diagnosed rheumatoid arthritis (RA) (mean age 64 ± 12 years, 14% women, 28% Black)
- Participants
- 8,852 veterans
- Exposure
- Hydroxychloroquine vs another nonbiologic disease-modifying antirheumatic drug (DMARD)
- Hydroxychloroquinen = 4,426
- Other DMARDn = 4,426reference
- Outcome
- LQTS during 19-year follow-up through December 31, 2019
- Follow-up
- 19 years
Methodological detailspropensity score-matched, active-comparator, balanced on 87 baseline characteristics
- Propensity score-matched
- Active-comparator
- Balanced on 87 baseline characteristics
Main finding
As reported in the abstract
Incident LQTS, first 2 years
Observational data: associations, not effects.
Further findings
Incident LQTS, 5 years · 11 additional LQTS events with hydroxychloroquine
NNH 403 (217–1,740)
| Outcome | HR (95% CI) | |
|---|---|---|
| LQTS, overall 10-year risk | 2.17 (1.13–4.18) | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Relative risk increase (95% CI) | P value |
|---|---|---|
| Incident LQTS, 5 years | 181% (11%–613%) | P = 0.030 |
- Long QT syndrome (LQTS), overall 10-year risk — Extra LQTS with hydroxychloroquine, years 6-10
- 5
- LQTS, overall 10-year risk — Extra LQTS with hydroxychloroquine, years 11-19
- 1
Arrhythmia-related hospitalization and all-cause mortality
- No association
Original publication
Hydroxychloroquine and Risk of Long QT Syndrome in Rheumatoid Arthritis: A Veterans Cohort Study With Nineteen‐Year Follow‐up. Arthritis Care Res (Hoboken). Published 31 January 2023. doi:10.
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