[Antimalarials. A treatment option for every lupus patient!?]

Area of Science:

• Rheumatology
• Pharmacology

Context:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
• Cardiovascular disease and thrombotic events are major complications in SLE patients.
• Current SLE treatments have limitations in efficacy, safety, or cost.

Purpose:

• To highlight the established benefits of antimalarials, specifically chloroquine and hydroxychloroquine, in managing SLE.
• To emphasize the underutilization of these effective and inexpensive treatments in clinical practice.
• To advocate for increased consideration of antimalarials in SLE management, particularly in early disease stages.

Summary:

• Chloroquine and hydroxychloroquine are approved and effective treatments for SLE, reducing disease flares and maintaining remission.
• Antimalarials offer additional benefits including protection against thrombotic events and improved cardiovascular risk factors.
• Hydroxychloroquine is uniquely effective in preventing irreversible damage accrual in SLE patients.
• These medications are well-tolerated, inexpensive, and should be considered for all SLE patients without contraindications.

Impact:

• Increased use of antimalarials could improve long-term outcomes for SLE patients by reducing disease activity and preventing damage.
• Wider adoption may lead to better cardiovascular risk management in this high-risk population.
• Promoting antimalarial use can enhance cost-effectiveness in SLE management, especially compared to newer therapies.