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Protective Effects of Hydroxychloroquine against Accelerated Atherosclerosis in Systemic Lupus Erythematosus

Alberto Floris1, Matteo Piga1, Arduino Aleksander Mangoni2

  • 1Rheumatology Unit, University Clinic and AOU of Cagliari, Monserrato, Italy.

Mediators of Inflammation
|April 20, 2018
PubMed

Insights

Systemic lupus erythematosus (SLE) patients face high cardiovascular risks due to accelerated atherosclerosis. Hydroxychloroquine (HCQ) shows promise in mitigating these risks by targeting inflammation and improving cardiovascular factors.

Area of Science:

  • Rheumatology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular (CV) morbidity and mortality pose significant challenges in managing systemic lupus erythematosus (SLE).
  • Accelerated atherosclerosis is a primary driver of increased CV disease risk in SLE patients, but traditional risk factors do not fully account for this elevated risk.
  • The complex interplay between SLE pathogenesis and atherosclerosis contributes to CV complications.

Purpose of the Study:

  • To review the evidence supporting the role of hydroxychloroquine (HCQ) in protecting against accelerated atherosclerosis and CV events in SLE patients.
  • To explore the mechanisms by which HCQ may exert beneficial CV effects in SLE.

Main Methods:

  • Literature review of studies investigating HCQ's effects on CV risk in SLE patients.
  • Analysis of HCQ's impact on atherosclerosis pathways, including inflammation, oxidative stress, and endothelial function.
  • Examination of HCQ's influence on traditional CV risk factors like dyslipidemia and diabetes.

Main Results:

  • Hydroxychloroquine (HCQ) is a foundational treatment for SLE, offering benefits in disease activity, damage prevention, and mortality.
  • HCQ demonstrates potential cardioprotective effects by targeting key pathways involved in accelerated atherosclerosis, such as toll-like receptor signaling, cytokine production, immune cell activation, oxidative stress, and endothelial dysfunction.
  • Evidence suggests HCQ may also improve traditional CV risk factors, including dyslipidemia and diabetes, in SLE patients.

Conclusions:

  • While definitive randomized controlled trials are lacking, the reviewed evidence suggests hydroxychloroquine (HCQ) offers beneficial effects against accelerated atherosclerosis and cardiovascular events in patients with systemic lupus erythematosus (SLE).
  • HCQ's multifaceted mechanisms of action support its role in cardiovascular risk reduction for SLE patients.

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