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Hydroxychloroquine Effects on Lipoprotein Profiles (the HELP trial): A Double-Blind, Randomized, Placebo-Controlled,

A Kavanaugh1, B Adams-Huet, R Jain

  • 1The Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, and the Department of Veterans Affairs Medical Center at Dallas, Texas.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2008
PubMed

Insights

Hydroxychloroquine significantly lowers total cholesterol in patients with systemic lupus erythematosus (SLE). This lipid-lowering effect, observed in a controlled trial, may offer added cardiovascular benefits for SLE patients.

Area of Science:

  • Rheumatology
  • Cardiology
  • Pharmacology

Background:

  • Systemic lupus erythematosus (SLE) is associated with an increased risk of atherosclerotic cardiovascular disease.
  • Dyslipidemia is a common comorbidity in SLE patients, contributing to cardiovascular risk.
  • Hydroxychloroquine is a standard treatment for SLE, but its lipid-modulating effects require further investigation.

Purpose of the Study:

  • To evaluate the efficacy of hydroxychloroquine in reducing total cholesterol and other lipoproteins in patients with SLE.
  • To compare the lipid-lowering effects of different hydroxychloroquine dosages (400 mg and 800 mg daily) against a placebo.

Main Methods:

  • A double-blind, randomized, placebo-controlled, multiple-dose pilot study.
  • Seventeen female patients with SLE were enrolled.
  • Lipoprotein panels, disease activity, and adverse effects were assessed at baseline and monthly follow-ups over three months.

Main Results:

  • No significant lipoprotein alterations were observed in the placebo group.
  • Hydroxychloroquine at 400 mg/day significantly decreased total cholesterol (mean 11.6 mg/dL).
  • Hydroxychloroquine at 800 mg/day significantly decreased total cholesterol (mean 13.4 mg/dL), triglycerides, VLDL, and LDL/HDL ratios. Higher adverse effects were noted at the 800 mg dose.

Conclusions:

  • Hydroxychloroquine demonstrates a significant lipid-lowering effect in patients with SLE.
  • The findings support previous open-label trials, suggesting a potential cardiovascular benefit.
  • This lipid-modulating property may be an advantageous effect of hydroxychloroquine in SLE management.

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