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Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients
Author(s) -
Morris Stephanie J.,
Wasko Mary Chester M.,
Antohe Jana L.,
Sartorius Jennifer A.,
Kirchner H. Lester,
Dancea Sorina,
Bili Androniki
Publication year - 2011
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20393
Subject(s) - medicine , dyslipidemia , rheumatoid arthritis , hydroxychloroquine , body mass index , cholesterol , cohort , lipid profile , endocrinology , gastroenterology , disease , covid-19 , infectious disease (medical specialty)
Objective Cardiovascular disease (CVD) is the leading cause of death in patients with rheumatoid arthritis (RA). Disease‐modifying therapies that improve risk factors for CVD, such as dyslipidemia, are desired. This study used an electronic health record to determine if hydroxychloroquine (HCQ) use was associated with an improvement in lipid levels in an inception RA cohort. Methods All adult individuals with the initial diagnosis of RA between January 1, 2001, and March 31, 2008, were identified (n = 1,539). Only patients with at least one lipid level post–RA diagnosis were included (n = 706). Information on demographics, medical history, body mass index (BMI), laboratory measures, and medications were collected at office visits. Potential risk and protective factors for dyslipidemia were controlled for in linear mixed‐effects regression models for low‐density lipoprotein (LDL), high‐density lipoprotein (HDL), total cholesterol, triglycerides, LDL/HDL, and total cholesterol/HDL. Results Patients were 69% women and 98% white, with a median age of 65 years and a median BMI of 29.8 kg/m 2 . In the adjusted regression models, HCQ use was associated with the following average differences in lipids: LDL decrease of 7.55 mg/dl ( P < 0.001), HDL increase of 1.02 mg/dl ( P = 0.20), total cholesterol decrease of 7.70 mg/dl ( P = 0.002), triglycerides decrease of 10.91 mg/dl ( P = 0.06), LDL/HDL decrease of 0.136 ( P = 0.008), and total cholesterol/HDL decrease of 0.191 ( P = 0.006), which were stable over time. Conclusion Use of HCQ in this RA cohort was independently associated with a significant decrease in LDL, total cholesterol, LDL/HDL, and total cholesterol/HDL. Considering these results, its safety profile, and low cost, HCQ remains a valuable initial or adjunct therapy in this patient population at high risk for CVD.