Hydroxychloroquine is neutral on incidental cataracts in patients with rheumatoid arthritis

To study whether hydroxychloroquine (HCQ) therapy increases the risks of cataracts in patients with rheumatoid arthritis (RA). In this retrospective cohort study, 2821 treatment-naive RA patients, collected from the Longitudinal Health Insurance Database, were enrolled from 2000 to 2012 and followed up monthly until secondary cataracts were detected but no later than Dec 31, 2013. All participants were split into two groups according to the usage of HCQ in one year: the HCQ group (465 patients), with a usage duration higher than 90 days, and the non-HCQ group (465 patients), with a usage duration less than 30 days. The HCQ and non-HCQ groups were age-, sex-, complication- and drug combination-matched. There was no significant difference in survival rate between the two groups (p > 0.05). A multivariate logistic regression model was applied. Of all participants, 173 were diagnosed with secondary cataracts in both the HCQ and non-HCQ groups, with 28.8/1000 and 36.5/1000 person-years, respectively. After adjustments for other predictors, patients in the HCQ group had no increased (or decreased/equal) hazard of secondary cataract (hazard ratio (HR): 1.17; confidence interval (CI): 0.86-1.59; p > 0.05). HR analysis of HCQ usage duration, age, sex and corticosteroids showed that the CI of the adjusted HR was not statistically significant. This study showed that HCQ usage was not associated with the risk of cataracts in RA patients.