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Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort{

Rheumatology Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel.; ymolad{at}clalit.org.il

A Gorshtein

Rheumatology Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel; Rheumatology Service, Assaf Harofeh Hospital, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

A J Wysenbeek

Rheumatology Service, Assaf Harofeh Hospital, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

D Guedj

R Majadla

A Weinberger

Rheumatology Unit, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel

M Amit-Vazina

Rheumatology Service, Assaf Harofeh Hospital, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Systemic lupus erythematosus-associated irreversible organ/system damage was previously associated with various clinical and demographic features. We analysed the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) in a cohort of 151 Israeli patients followed for a mean ( s.d.) period of 45.7 37.4 months. Mean score of SLICC/ACR DI at the first and last encounters were 0.17 64 and 1.64 2.1, respectively (P < 0.0001). Multiple logistic regression analyses disclosed a statistically significant positive correlation with corticosteroid and cyclophosphamide therapy. Hydroxychloroquine therapy was significantly associated with lower SLICC/ACR DI. Although the size of our study group did not allow us to find specific organs/systems which were associated with the protective effect of hydroxychloroquine, we suggest this is due to the antiatherogenic effects attributed to antimalarial therapy in SLE.

Key Words: damage • lupus • activity • hydroxychloroquine • antimalarial therapy

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