Cited by 291Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVenous Thromboembolism Diagnosis and Management

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The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus

Jung, Hyejung, Bobba, Raja, Su, Jiandong, Shariati‐Sarabi, Zhaleh, Gladman, Dafna D., Urowitz, Murray, Lou, Wendy, Fortin, Paul R.·2010·Arthritis & Rheumatism

DOI 10.1002/art.27289

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Abstract

Objective: The antimalarial medication hydroxychloroquine has been proposed as a thromboprotective agent in systemic lupus erythematosus (SLE), but studies thus far have been limited by the possibility of confounding by indication. This study was conducted to assess whether exposure to antimalarial drugs is associated with a decrease in thrombovascular events (TEs) in patients with SLE. Methods: The study was designed as a nested case–control study embedded in an inception cohort of patients with SLE, which allowed adjustments for possible confounding by calendar year, duration of disease, duration of observation, and severity of lupus. After controlling for the possible confounding variables in conditional logistic regression models, the use of antimalarial drugs was assessed for its effects on the development of TEs in lupus patients. Results: Fifty‐four cases of TE were identified, and these were matched with 108 control subjects (lupus patients without TEs). Univariate analyses identified older age (odds ratio [OR] 1.04, 95% confidence interval [95%CI] 1.01–1.07) or being older than age 50 years (OR 3.5, 95% CI 1.4–8.6) and ever having hypertension (OR 2.5, 95% CI 1.0–5.8) as being associated with an increased risk of TEs, whereas use of antimalarial drugs (OR 0.31, 95% CI 0.13–0.71) was associated with a decreased risk of TEs. Separate analyses were done for arterial and venous TEs, which yielded similar results. In multivariate analyses, use of antimalarial drugs (OR 0.32, 95% CI 0.14–0.74) and older age (OR 1.04, 95% CI 1.01–1.07) were the only 2 variables that remained significant. Conclusion: The results from this nested case–control study demonstrate that, after accounting for the effects of disease severity, disease duration, and calendar year, antimalarial drugs were found to be thromboprotective, being associated with a 68% reduction in the risk of all TEs, with a range of risk reduction of at least 26% up to as high as 86%.

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Authors: Jung, H., Bobba, R., Su, J., Shariati‐Sarabi, Z., Gladman, D. D., Urowitz, M., Lou, W., & Fortin, P. R.
Affiliations: University of Toronto (CA)
McMaster University (CA)
Mashhad University of Medical Sciences (IR)
ORCID: Jung, Hyejung
Su, Jiandong
Shariati‐Sarabi, Zhaleh
Gladman, Dafna D.
Urowitz, Murray
Lou, Wendy
Fortin, Paul R.
Venue: Arthritis & Rheumatism
Publisher: Wiley
Published: 2010-02-25
Volume: 62
Issue: 3
Pages: 863-868
ISSN: 0004-3591 (ISSN-L)
1529-0131
DOI: 10.1002/art.27289
OpenAlex: W2024228574
Cited by: 291
References: 33
Citations by year: 2026: 7 · 2025: 11 · 2024: 17 · 2023: 9 · 2022: 18 · 2021: 28 · 2020: 20 · 2019: 15 · 2018: 24 · 2017: 22 · 2016: 23 · 2015: 16 · 2014: 23 · 2013: 16 · 2012: 22
FWCI: 12.71
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Arthritis & Rheumatism (publishedVersion)
PubMed (publishedVersion)
Funders: University of Toronto
Canadian Institutes of Health Research (49509_1, 64336_1)
Topics: Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Keywords: hydroxychloroquine, antimalarial drugs, systemic lupus erythematosus, venous thromboembolism, arterial thromboembolism, hypertension, age as risk factor, confounding by indication
MeSH terms: Adult, Antimalarials, Female, Humans, Hydroxychloroquine, Lupus Erythematosus, Systemic, Male, Middle Aged, Thrombosis

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The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus

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