1. Hydroxychloroquine significantly improves the lipid profile in patients with rheumatoid arthritis and systemic lupus erythematosus

Evidence Rating Level: 1 (Excellent)

Patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have an increased morbidity and mortality from cardiovascular disease (CVD) due to the inflammatory nature of these conditions. Several observational studies have shown a reduction in in CVD risk in these patients if treated with hydroxychloroquine (HCQ). This interventional study was done to evaluate the effect of HCQ treatment on the CVD risk factors (blood lipids, glucose metabolism, and blood pressure) in patients with RA or SLE. Four weeks after the initiation of HCQ, total cholesterol, LDL, and ApoB levels were significantly reduced. HDL, triglycerides, ApoA1 and Lp(a) levels did not change significantly. HbA1c decreased in most patients with greater changes seen in those with higher initial HbA1c (correlation coefficient -0.77, p<0.0001). Vascular function analysis done with Arteriograph® showed no significant changes in pulse-wave velocity, aortic or brachial augmentation index, aortic blood pressure or pulse pressure during the 8-week treatment with HCQ. These results suggest that HCQ treatment in patients with RA and SLE shows a significant improvement of lipid status and decreased HbA1c. The main limitation is the sample size which included 25 patients with RA and 7 with SLE. Future studies should validate this with larger cohorts. 

Click to read the study in PLOSONE

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