Research article shows that taking hydroxychloroquine decreases the risk of death by 83%:
Impact of Antimalarial Adherence on Mortality Among Patients With Newly Diagnosed Systemic Lupus Erythematosus: A Population-Based Cohort Study
Hoque MR, Aviña-Zubieta JA, De Vera MA, Qian Y, Esdaile JM, Xie H. Arthritis Care Res (Hoboken). 2022 Jul;74(7):1089-1097. doi: 10.1002/acr.24550. Epub 2022 Apr 6. PMID: 33411964.
– Lupus patients who take their hydroxychloroquine regularly had an 83% lower risk of death compared to those who stopped taking it
– They had a 71% lower risk of death compared to those who did not take it regularly
– Lupus patients who miss doses of hydroxychloroquine should figure out strategies to help prevent missing doses
What we already know about how hydroxychloroquine decreases death
- Close to 1 out of 2 lupus patients are poorly adherent with taking their medications regularly
- Taking hydroxychloroquine regularly is part of “The Lupus Secrets“
- Hydroxychloroquine has many benefits while being relatively safe (as long as people get their yearly eye exams)
- One of my favorite quotes is from Dr. Michelle Petri at the Johns Hopkins Lupus Center: “Hydroxychloroquine is the only drug proven to prolong survival for lupus patients.”
Hydroxychloroquine is the only drug proven to prolong survival for lupus patients.
Dr. Michelle Petri, MD, Director, Lupus Center, Johns Hopkins Hospital, Baltimore, MD
What this study adds to our knowledge about hydroxychloroquine and lupus deaths
It strengthens the importance of taking hydroxychloroquine regularly
How the study was done (in brief)
Location: British Columbia, Canada
Patients: 3062 systemic lupus erythematosus patients followed between January 1997 and March 2015
Method:
- A retrospective chart review study
- Observational
- No placebo group
What should be studied in the future about hydroxychloroquine and lupus
- What causes of death, in particular, are lowered by taking hydroxychloroquine regularly
- What is the optimal dose of hydroxychloroquine, or target hydroxychloroquine drug level, that lowers mortality best
- What are the best strategies to help lupus patients not forget doses of medicines
- Figure out how to make access to medications, like hydroxychloroquine, more easily accessible for all patients
13 Comments
I took Plaquenil and had my yearly exams for over ten years. The last eye exam showed it was starting to affect my eyes and I had to stop taking it. Hopefully the years I was able to take Plaquenil put me in a good place. I am a 32-year survivor.
Kathy: So sorry to hear that. A couple of thoughts… 1) quinacrine is now available again. It is a viable substitute for HCQ. Also, though HCQ is the only drug proven to prolong survival in SLE patients, I suspect that belimumab (Benlysta) could easily show the same thing after further watching. We already know from the 7 year and 13 year long term study results, it shows that it lowers organ damage in lupus patients and is well tolerated.
Donald Thomas, MD
I have been taking Plaquenil for 30 years. Last summer I had special tests run to assess the health of my eyes. Everything good. I also get regular yearly checks of my eyes. It is such an easy medicine to take. For me no side affects. It brings me comfort to know I am actively managing my SLE with this medicine and contributing to better outcomes and a healthier today and tomorrow for myself.
Thanks for sharing your story with others, Penelope.
Dr T
What is the death rate when combined with other diseases?Eg, Sjögren’s syndrome, fibromyalgia.
Lisa: that is such an important question, and I do not recall any studies sorting out how patients do who only have lupus and those who have overlap syndromes (such as Sjogren’s) or concomitant fibromyalgia. I’ll be on the lookout though, and if I see a study, I’ll report on it.
Donald Thomas, MD
Is that plaquinil or just any hydroxycloroquine?
Both generic HCQ and brand name Plaquenil
Donald Thomas, MD
It didn’t sit will with me. Terrible headaches
I have been on chloroquine since 2013 I am supposed to be taking it everyday but I reduced it to 3 times a week for the fear of it affecting my eyes. I would rather stay on chloroquine than switch to methotrexate as I have heard this drug can cause cancer. Would like some thoughts on this?
Vanishree: You are correct. MTX has been associated with non-melanoma skin cancers (basal cell and squamous cell). Interestingly, also with a particular type of lymphoma that is related to Epstein Barr Virus. But when MTX is stopped, it goes away.
Donald Thomas, MD
Should a person with lupus take a probiotic pill?
Cindy: I recommend “no.” Reason being… probiotic studies in animal models show that some probiotic bacteria worsen some autoimmune disease, while helping others. Some that worsened lupus are found in some pills.
A healthy microbiome (gut bacteria) appears to be incredibly important in SLE, and getting probiotics through diet, and prebiotics as well (resistant starches) is probably better.
See my article on lupus and diet and probiotics here: https://www.lupusencyclopedia.com/latest-anti-inflammatory-diet-for-lupus-and-other-autoimmune-diseases/
Thank you for asking,
Donald Thomas, MD