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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Hydroxychloroquine: a multifaceted treatment in lupus.
Nathalie Costedoat-Chalumeau1, Bertrand Dunogué1, Nathalie Morel1
1AP-HP, université René-Descartes Paris V, hôpital Cochin, centre de référence maladies auto-immunes et systémiques rares, pôle médecine, service de médecine interne, 75679 Paris cedex 14, France.
Presse Medicale (Paris, France : 1983)
|May 24, 2014
Summary
Hydroxychloroquine (HCQ) effectively prevents systemic lupus erythematosus (SLE) flares and offers survival benefits. Despite its advantages, HCQ use in SLE patients remains low, highlighting a need for increased prescription.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Hydroxychloroquine (HCQ) is a proven antimalarial for preventing systemic lupus erythematosus (SLE) flares.
- Despite demonstrated efficacy, HCQ prescription rates in SLE patients are suboptimal.
- HCQ's mechanism involves blocking toll-like receptors 7 and 9, inhibiting crucial interferon-alpha production in SLE pathogenesis.
Purpose of the Study:
- To review the benefits and risks of hydroxychloroquine (HCQ) in managing systemic lupus erythematosus (SLE).
- To highlight the importance of HCQ adherence and its role in improving patient outcomes.
- To emphasize the favorable risk-benefit profile of HCQ for SLE patients.
Main Methods:
- Literature review of studies on hydroxychloroquine (HCQ) in systemic lupus erythematosus (SLE).
- Analysis of HCQ's pharmacological and pharmacokinetic properties.
- Evaluation of HCQ's efficacy, safety, and impact on SLE patient survival and comorbidities.
Main Results:
- HCQ reduces SLE flares, damage accrual, and comorbidities like diabetes and thrombotic events.
- Low or undetectable blood HCQ levels indicate non-adherence, a factor impacting treatment effectiveness.
- Retinal toxicity is the primary, though rare, contraindication, necessitating regular screening.
Conclusions:
- The risk-benefit ratio of HCQ in SLE is excellent, with recommended use during pregnancy and breastfeeding.
- HCQ offers significant benefits including improved survival and protection against comorbidities.
- There is a strong rationale for offering HCQ to all systemic lupus erythematosus patients.
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