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Quinacrine added to ongoing therapeutic regimens attenuates anticardiolipin antibody production in SLE

Divisions of Clinical Immunology, Bnai-Zion Medical Center, Haifa, Israel

A Kessel

Divisions of Clinical Immunology, Bnai-Zion Medical Center, Haifa, Israel

I Rosner

Division of Rheumatology, Bnai-Zion Medical Center, Haifa, Israel

M Rozenbaum

Division of Rheumatology, Bnai-Zion Medical Center, Haifa, Israel

M Lorber

Division of Clinical Immunology, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel

D Paran

Department of Rheumatology, Sourasky Medical Center, Tel-aviv University, Israel

E Sabo

Divisions of Clinical Immunology, Bnai-Zion Medical Center, Haifa, Israel

T D Golan

Divisions of Clinical Immunology, Bnai-Zion Medical Center, Haifa, Israel

The benefit of combining quinacrine (Qn) with hydroxychloroquine (HCQ) in the treatment of systemic lupus erythematosus (SLE) was previously re-evaluated by us. In our current study we observed that, in 11 active SLE patients (SLEDAI score 5 - 12), the addition of Qn (100 mg=day) to their existing ongoing therapeutic regimens resulted in a significant attenuation of their previously persistent anticardiolipin antibody (aCL) response. This was in comparison with a matched non-Qn treated control group composed of 14 randomly chosen aCL-positive SLE patients with a similar SLEDAI score 6 - 10. Prior to Qn treatment the therapeutic regimens of 12 months’ duration, included in all cases HCQ (400 mg=day), in many cases prednisone (P, 10 - 20 mg=day) and in some additional cases immunosuppressive drugs. SLEDAI scores and aCL levels were monitored during the entire follow-up period which totaled 24 months in the study group and 15 - 18 months in the controls. Along with the beneficial effect of the added Qn on SLEDAI scores, aCL disappearance was documented in eight of 11 patients and remained negative during 8 - 12 months of follow-up (P = 0.004), compared with such a change in only three of 14 non-Qn treated aCL-positive patients (P = 0.18). We conclude that the added Qn treatment to former established therapeutic protocols may eliminate aCL response in SLE patients. Whether this agent’s effect is permanent needs further elucidation.

Key Words: quinacrine • hydroxychloroquine • SLE • anticardiolipin

Lupus, Vol. 12, No. 4, 297-301 (2003)
DOI: 10.1191/0961203303lu319oa


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