Options for Long-Term Lupus Patients

Hydroxychloroquine for lupus patients may prevent long term damage from disease

(RxWiki News) Having a chronic illness means managing it over time to reduce its effects. Patients with lupus who properly manage their disease may be able to reduce its long-term impact.

A recent study found that a medication called hydroxychloroquine (brand name Plaquenil) can be used to prevent damage in lupus patients.

Damage can refer to organ damage, seizures, cataracts, high blood pressure, muscle weakness or many other conditions that lupus can cause.

Hydroxychloroquine is usually used to prevent malaria but has also been used to treat lupus symptoms, like rashes and arthritis.

"Discuss lupus treatment with your rheumatologist."

The study, led by Pooneh S. Akhavan, MD, of the Division of Rheumatology at the University of Toronto's Department of Medicine, aimed to find out whether hydroxychloroquine could help prevent damage to lupus patients over time.

The researchers searched the medical research literature for studies between 1982 and 2012 that had data on lupus patients.

The researchers pulled the information on 481 participants from these studies who had zero damage at the start of the study they were in and were followed for at least three years.

A total of 302 lupus patients were then included from this larger group, allowing the researchers to match two groups of patients.

Half of the patients had a "damage index" of 0 at the end of the three years, which means they had no additional damage from lupus over those three years.

The damage index score refers to how much organ damage and other conditions a person has experienced as a result of their lupus.

The other 151 patients had a damage index of more than 0 at three years. That means they had suffered some damage, though the amount varied across the patients.

Each patient who had some damage was matched to a patient who had no damage so that the researchers could see how they differed.

The researchers looked at patients' age, any immunosuppressive drugs they were taking, whether they were taking hydroxychloroquine and whether they were taking steroids.

The researchers found that the lupus patients who had taken hydroxychloroquine had a 66 percent lower risk of having damage.

Those who had an active disease and were taking steroids had a 73 percent greater risk of having damage.

These results showed that using hydroxychloroquine was linked to less damage in lupus patients.

Because patients with lupus are living longer presently, this medication may offer an option for reducing other conditions related to lupus, the researchers wrote.

Adverse effects (side effects) were reported to be low but were not discussed in detail in the study.

"Compared to other conventionally used immunomodulators, hydroxychloroquine is inexpensive, widely available, well tolerated, and has low toxicity," the authors wrote.

"Our findings are in support of the wide and early use of this medication in patients with lupus in the absence of contraindications," they wrote. Contraindications refer to conditions a person has which make it unsafe for them to take the medication.

The study was published in the May issue of The Journal of Rheumatology.

The research was funded by an award from the Arthritis Society and from the Arthritis Centre of Excellence, the University of Toronto and the Department of Medicine at Université Laval.

Research support also came from Lupus Canada, Lupus Ontario, the Lupus Foundation of Ontario, BC Lupus, the Toronto General and Western Hospital Foundation, Bristol-Myers Squibb Canada Inc., the Smythe Foundation, Dance for the Cure and Flare for Fashion.

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Review Date: 
May 30, 2013