Lupus & antiphospholipid syndrome
New insights into the long-term adverse effects of antimalarials in patients with systemic lupus erythematosus
Authors' conclusion
Patients with previous use of chloroquine, higher than recommended doses of hydroxychloroquine, and positive anti-ß2-glycoprotein antibodies were more likely to develop long-term antimalarial toxicity.
Study context
- Population
- Consecutively diagnosed systemic lupus erythematosus (SLE) patients followed for at least 5 years, 1998–2017, single reference centremedian follow-up 15 years
- Participants
- Three hundred 22 participants
- Exposure
- Long-term users vs Short-term users
- Outcome
- Antimalarial long-term adverse effect (occurring after at least 5 years of continuous antimalarial treatment) and its independent associated factors
Methodological detailssingle-centre, consecutively diagnosed patients, hazard regression analysis
- Single-centre
- Consecutively diagnosed patients
- Hazard regression analysis
Main finding
As reported in the abstract
Independent factors associated with long-term antimalarial toxicity
Hazard ratio (95% CI)
Previous use of chloroquine
3(1–9)
Anti-ß2-glycoprotein antibody positivity
2(1–4)
HCQ dose >5 mg/kg/day
2.6(1–7)
Observational data: associations, not effects.
Further findings
Incidence of all types of toxicity
P < 0.001
Antimalarial drugs started
- Patients started on antimalarials
- 314 (97.5%)
Safety
Adverse effects of antimalarials
- Any adverse effect
- 55 (17.5%)
- Macular toxicity (main adverse effect)
- 11.5%
Original publication
New insights into the long-term adverse effects of antimalarials in patients with systemic lupus erythematosus. Lupus. Published 27 January 2025. doi:10.
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