Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus
Abstract
Antimalarials have shown beneficial effects on systemic lupus erythematosus (SLE) activity. Our aim was to investigate whether antimalarials protect against thrombosis and influence survival in SLE patients. A prospective cohort including 232 patients with SLE were included in the study at the time of lupus diagnosis. End points were documented thrombosis and death due to any cause. A Cox regression-multiple-failure time survival analysis model was fitted to establish the effect of antimalarials on the development of thrombosis. Kaplan-Meier survival curves and propensity score adjusted-Cox regression analysis were performed to investigate the effect of antimalarials use on survival. Of our subjects, 204 patients (88%) were women. 230 patients (99%) were white. 150 patients (64%) had ever received antimalarials. Median time on antimalarials was 52 months (range three to 228 months). The Cox multiple-failure time survival analysis showed that taking antimalarials was protective against thrombosis (HR 0.28, 95%CI 0.08-0.90), while aPL-positivity (HR 3.16, 95%CI 1.45-6.88) and previous thrombosis (HR 3.85, 95%CI 1.50-9.91) increased the risk of thrombotic events. Twenty-three patients died, 19 of whom (83%) had never received antimalarials. No patient treated with antimalarials died of cardiovascular complications. Cumulative 15-year survival rates were 0.68 for never versus 0.95 for ever treated patients ( P < 0.001). Age at diagnosis and propensity score-adjusted HR for antimalarials ever versus never users was 0.14 (95%CI 0.04-0.48). Our study shows a protective effect of antimalarials against thrombosis and an increased survival of SLE patients taking these drugs. These data support the routine use of antimalarials in all patients with SLE.
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Current recommendations advise hydroxychloroquine for SLE patients with persistent moderate-to-high antiphospholipid antibodies or positive lupus anticoagulant for primary prevention (grade 1B to 2B), based on its other benefits in SLE and thrombosis.
“HCQ treatment is currently recommended for SLE patients with persistent moderate-high aPL Ab or LAC+ for primary prevention (grade 1B to 2B recommendation) based on the other beneficial effects of HCQ in SLE (12, 13) and thrombosis (14).”
In patients with systemic lupus erythematosus, long-term exposure to hydroxychloroquine is associated with a reduction in both first and recurrent thrombotic events, particularly in those with persistent antiphospholipid antibody positivity.
“In patients with SLE, long-term exposure to HCQ has consistently been associated with a reduction in both first and recurrent thrombotic events, particularly in those with persistent aPL positivity [6, 7].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [6]
In systemic lupus erythematosus, multiple observational studies have consistently shown that long-term antimalarial use reduces both first and recurrent thrombotic events, particularly among those with persistent antiphospholipid antibodies.
“Multiple observational studies have consistently shown that long-term antimalarial use reduces both first and recurrent thrombotic events in patients with SLE, particularly among those with persistent antiphospholipid antibodies [6, 7].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [6]
Cites
The central role of the propensity score in observational studies for causal effects
ROSENBAUM, P. R., & RUBIN, D. B. (1983) · Biometrika · doi:10.1093/biomet/70.1.41 · Cited by 31,241 · see citing works
The 1982 revised criteria for the classification of systemic lupus erythematosus
Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., Mcshane, D. J., Rothfield, N. F., Schaller, J. G., Talal, N., & Winchester, R. J. (1982) · Arthritis & Rheumatism · doi:10.1002/art.1780251101 · Cited by 14,519 · see citing works
Hochberg, M. C. (1997) · Arthritis & Rheumatism · doi:10.1002/art.1780400928 · Cited by 11,409 · see citing works
The Robust Inference for the Cox Proportional Hazards Model
Lin, D. Y., & Wei, L. J. (1989) · Journal of the American Statistical Association · doi:10.1080/01621459.1989.10478874 · Cited by 2,653 · see citing works
Manzi, S., Meilahn, E. N., Rairie, J. E., Conte, C. G., Medsger, T. A., Jansen-McWilliams, L., D’Agostino, R. B., & Kuller, L. H. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009122 · Cited by 1,831 · see citing works
Prevalence and Correlates of Accelerated Atherosclerosis in Systemic Lupus Erythematosus
Roman, M. J., Shanker, B., Davis, A., Lockshin, M. D., Sammaritano, L. R., Simantov, R., Crow, M. K., Schwartz, J. E., Paget, S. A., Devereux, R. B., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035471 · Cited by 1,422 · see citing works
Cervera, R., Khamashta, M. A., Font, J., Sebastiani, G. D., Gil, A., Lavilla, P., Mejía, J. C., Aydintug, A. O., Chwalinska-Sadowska, H., de Ramón, E., et al. (2003) · Medicine · doi:10.1097/01.md.0000091181.93122.55 · Cited by 1,377 · see citing works
Premature Coronary-Artery Atherosclerosis in Systemic Lupus Erythematosus
Asanuma, Y., Oeser, A. M., Shintani, A., Turner, E. L., Olsen, N. J., Fazio, S., Linton, M. F., Raggi, P., & Stein, C. M. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035611 · Cited by 890 · see citing works
Sequential Therapies for Proliferative Lupus Nephritis
Contreras, G. N., Pardo, V., Leclercq, B., Lenz, O., Tozman, E., O'Nan, P., & Roth, D. A. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa031855 · Cited by 815 · see citing works
Kirou, K. A., Lee, C., George, S., Louca, K., Peterson, M. G. E., & Crow, M. K. (2005) · Arthritis & Rheumatism · doi:10.1002/art.21031 · Cited by 702 · see citing works
The Canadian Hydroxychloroquine Study Group* (1991) · New England Journal of Medicine · doi:10.1056/nejm199101173240303 · Cited by 689 · see citing works
Sambrook, P. N., MacGregor, A. J., & Spector, T. D. (1999) · Arthritis & Rheumatism · doi:10.1002/1529-0131(199902)42:2 · Cited by 517 · see citing works
Illei, G. G., Austin, H. A., Crane, M., Collins, L., Gourley, M. F., Yarboro, C. H., Vaughan, E. M., Kuroiwa, T., Danning, C. L., Steinberg, A. D., et al. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-4-200108210-00009 · Cited by 487 · see citing works
Gladman, D. D., Goldsmith, C. H., Urowitz, M. B., Bacon, P. A., Fortin, P. R., Ginzler, E. M., Gordon, C., Hanly, J. G., Isenberg, D. A., Petri, M., et al. (2000) · PubMed · Cited by 477 · see citing works
Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus
Petri, M., Roubenoff, R., Dallal, G. E., Nadeau, M., Selhub, J., & Rosenberg, I. H. (1996) · The Lancet · doi:10.1016/s0140-6736(96)03032-2 · Cited by 418 · see citing works
Fessler, B. J., Alarcón, G. S., McGwin, G., Roseman, J. M., Bastian, H. M., Friedman, A., Baethge, B. A., Vilá, L. M., Reveille, J. D., & for the LUMINA Study Group (2005) · Arthritis & Rheumatism · doi:10.1002/art.21039 · Cited by 377 · see citing works
Erkan, D. (2002) · Rheumatology · doi:10.1093/rheumatology/41.8.924 · Cited by 330 · see citing works
Petri, M., Lakatta, C., Magder, L., & Goldman, D. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90151-1 · Cited by 323 · see citing works
Toloza, S., Uribe, A. G., McGwin, G., Alarcón, G. S., Fessler, B. J., Bastian, H. M., Vilá, L. M., Wu, R., Shoenfeld, Y., Roseman, J. M., et al. (2004) · Arthritis & Rheumatism · doi:10.1002/art.20622 · Cited by 319 · see citing works
Mortality and causes of death in systemic lupus erythematosus
Trager, J., & Ward, M. M. (2001) · Current Opinion in Rheumatology · doi:10.1097/00002281-200109000-00002 · Cited by 264 · see citing works
Hydroxychloroquine use in the Baltimore Lupus Cohort: effects on lipids, glucose and thrombosis
Petri, M. (1996) · Lupus · doi:10.1177/0961203396005001051 · Cited by 259 · see citing works
Hydroxychloroquine Reverses Thrombogenic Properties of Antiphospholipid Antibodies in Mice
Edwards, M. H., Pierangeli, S., Liu, X., Barker, J. H., Anderson, G., & Harris, E. N. (1997) · Circulation · doi:10.1161/01.cir.96.12.4380 · Cited by 250 · see citing works
PREMATURE ATHEROSCLEROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Bruce, I. N., Gladman, D. D., & Urowitz, M. B. (2000) · Rheumatic Disease Clinics of North America · doi:10.1016/s0889-857x(05)70138-1 · Cited by 241 · see citing works
Hydroxychloroquine Reverses Platelet Activation Induced by Human IgG Antiphospholipid Antibodies
Espinola, R., Ghara, A., Harris, E., & Pierangeli, S. (2002) · Thrombosis and Haemostasis · doi:10.1055/s-0037-1613033 · Cited by 240 · see citing works
Ruiz‐Irastorza, G., Egurbide, M.-V., Ugalde, J., & Aguirre, C. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.1.77 · Cited by 238 · see citing works
Self-citationMok, C. C., Tang, S. S. K., To, C. H., & Petri, M. (2005) · Arthritis & Rheumatism · doi:10.1002/art.21224 · Cited by 237 · see citing works
Wallace, D. J., METZGER, A. L., Stecher, V. J., Turnbull, B. A., & Kern, P. A. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90345-e · Cited by 230 · see citing works
Øhlenschlæger, T. F., Garred, P., MADSEN, H. O., & Jacobsen, S. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa033122 · Cited by 197 · see citing works
Thrombosis and Systemic Lupus Erythematosus: The Hopkins Lupus Cohort Perspective
Petri, M. (1996) · Scandinavian Journal of Rheumatology · doi:10.3109/03009749609069986 · Cited by 176 · see citing works
Biochemical characterization of ADP-ribose polymer metabolism in SLE
Chen, H.-Y., Pertusi, R. M., Kirkland, J., Rubin, B. R., & Jacobson, E. L. (1996) · Lupus · doi:10.1177/096120339600500105 · Cited by 162 · see citing works
Ibañez, D., Urowitz, M. B., & Gladman, D. D. (2003) · PubMed · Cited by 161 · see citing works
Borba, E. F., & Bonfá, E. (2001) · PubMed · Cited by 145 · see citing works
Systemic Lupus Erythematosus and Accelerated Atherosclerosis
Hahn, B. H. (2003) · New England Journal of Medicine · doi:10.1056/nejmp038168 · Cited by 136 · see citing works
Molad, Y., Gorshtein, A., Wysenbeek, A. J., Guedj, D., Majadla, R., Weinberger, A., & Amit-Vazina, M. (2002) · Lupus · doi:10.1191/0961203302lu203ra · Cited by 134 · see citing works
Controlled trial with chloroquine diphosphate in systemic lupus erythematosus
Meinão, I., Sato, E. I., Andrade, L. E. C., Ferraz, M., & Atra, E. (1996) · Lupus · doi:10.1177/096120339600500313 · Cited by 131 · see citing works
Ho, K. T., Ahn, C. W., Alarcón, G. S., Baethge, B. A., Tan, F. K., Roseman, J., Bastian, H. M., Fessler, B. J., McGwin, G., Vilá, L. M., et al. (2005) · Rheumatology · doi:10.1093/rheumatology/kei014 · Cited by 128 · see citing works
Effect of antimalarial agents on the fasting lipid profile in systemic lupus erythematosus.
Tam, L., Gladman, D. D., Hallett, D. C., Rahman, P., & Urowitz, M. B. (2000) · PubMed · Cited by 127 · see citing works
Does hydroxychloroquine sulfate prevent clot formation in systemic lupus erythematosus?
Wallace, D. J. (1987) · Arthritis & Rheumatism · doi:10.1002/art.1780301219 · Cited by 124 · see citing works
Merrill, J. T., & Lahita, R. G. (1996) · Lupus · doi:10.1177/096120339600500103 · Cited by 120 · see citing works
Wallace, D. J., Linker‐Israeli, M., METZGER, A. L., & Stecher, V. J. (1993) · Lupus · doi:10.1177/0961203393002001041 · Cited by 111 · see citing works
The Cardiovascular Burden of Lupus
Schattner, A., & Liang, M. H. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.13.1507 · Cited by 59 · see citing works
Urowitz, M. B., & Gladman, D. D. (2005) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2005.01.008 · Cited by 59 · see citing works
Development and preliminary validation of a Children's Arthritis Self-Efficacy Scale
Barlow, J., Shaw, K. L., & Wright, C. C. (2001) · Arthritis & Rheumatism · doi:10.1002/1529-0131(200104)45:2 · Cited by 39 · see citing works
Hansen, E., Jessing, P., Lindewald, H., Østergaard, P., Olesen, T., & Malver, E. (1976) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-197658080-00008 · Cited by 27 · see citing works
Martínez-Berriotxoa, A., Ruiz‐Irastorza, G., Egurbide, M.-V., Rueda, M., & Aguirre, C. (2004) · Lupus · doi:10.1191/0961203304lu2035oa · Cited by 26 · see citing works
Self-citationHo (2001) · Pure Amsterdam UMC · doi:10.1002/1529-0131(200110)44:10 · Cited by 3 · see citing works
Wilson (1999) · doi:10.1002/1529-0131(199907)42:7
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KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases
Rovin, B. H., Adler, S. G., Barratt, J., Bridoux, F., Burdge, K. A., Chan, T. M., Cook, H. T., Fervenza, F. C., Gibson, K. L., Glassock, R. J., et al. (2021) · Kidney International · doi:10.1016/j.kint.2021.05.021 · Cited by 2,661 · see citing works
Ruiz-Irastorza, G., Ramos-Casals, M., Brito-Zeron, P., & Khamashta, M. A. (2010) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.101766 · Cited by 978 · see citing works
Self-citationCervera, R., Serrano, R., Pons-Estel, G. J., Ceberio-Hualde, L., Shoenfeld, Y., de Ramón, E., Buonaiuto, V, Jacobsen, S., Zeher, M. M., Tarr, T., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-204838 · Cited by 974 · see citing works
Systemic lupus erythematosus: Diagnosis and clinical management
Fava, A., & Petri, M. (2018) · Journal of Autoimmunity · doi:10.1016/j.jaut.2018.11.001 · Cited by 793 · see citing works
Treat-to-target in systemic lupus erythematosus: recommendations from an international task force
van Vollenhoven, R., Mosca, M., Bertsias, G. K., Isenberg, D. A., Kuhn, A., Lerstrøm, K., Aringer, M., Bootsma, H., Boumpas, D., Bruce, I. N., et al. (2014) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-205139 · Cited by 750 · see citing works
KDIGO 2024 Clinical Practice Guideline for the management of LUPUS NEPHRITIS
Rovin, B. H., Ayoub, I. M., Chan, T. M., Liu, Z.-H., Mejia-Vilet, J. M., & Floege, J. (2024) · Kidney International · doi:10.1016/j.kint.2023.09.002 · Cited by 557 · see citing works
Alarcón, G. S., McGwin, G., Bertoli, A. M., Fessler, B. J., Alén, J. C., Bastian, H. M., Vilá, L. M., & Reveille, J. D. (2007) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2006.068676 · Cited by 524 · see citing works
Schreiber, K. I., Sciascia, S., de Groot, P. G., Devreese, K. M. J., Jacobsen, S., Ruiz‐Irastorza, G., Salmon, J. E., Shoenfeld, Y., Shovman, O., & Hunt, B. J. (2018) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2017.103 · Cited by 437 · see citing works
Self-citationPredictors of major infections in systemic lupus erythematosus
Ruiz‐Irastorza, G., Olivares, N., Ruiz‐Arruza, I., Martínez-Berriotxoa, A., Egurbide, M.-V., & Aguirre, C. (2009) · Arthritis Research & Therapy · doi:10.1186/ar2764 · Cited by 371 · see citing works
Self-citationSchoenfeld, S. R., Kasturi, S., & Costenbader, K. H. (2013) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2012.12.002 · Cited by 370 · see citing works
The role of platelets in immune-mediated inflammatory diseases
Scherlinger, M., Richez, C., Tsokos, G. C., Boilard, É., & Blanco, P. (2023) · Nature reviews. Immunology · doi:10.1038/s41577-023-00834-4 · Cited by 357 · see citing works
Tektonidou, M. G., Laskari, K., Panagiotakos, D. B., & Moutsopoulos, H. M. (2009) · Arthritis Care & Research · doi:10.1002/art.24232 · Cited by 356 · see citing works
Changing Patterns in Mortality and Disease Outcomes for Patients with Systemic Lupus Erythematosus
Urowitz, M. B., Gladman, D. D., Tom, B. D. M., Ibañez, D., & Farewell, V. T. (2008) · The Journal of Rheumatology · doi:10.3899/jrheum.080214 · Cited by 327 · see citing works
Ruiz‐Irastorza, G., Egurbide, M.-V., Olivares, N., Martínez-Berriotxoa, A., & Aguirre, C. (2008) · Rheumatology · doi:10.1093/rheumatology/ken121 · Cited by 327 · see citing works
Self-citationErkan, D., Aguiar, C. L., ANDRADE, D. C. O. D., Cohen, H., Cuadrado, M. J., Danowski, A., Levy, R. A., Ortel, T. L., Rahman, A., Salmon, J. E., et al. (2014) · Autoimmunity Reviews · doi:10.1016/j.autrev.2014.01.053 · Cited by 317 · see citing works
Pons‐Estel, G., Alarcón, G. S., McGwin, G., Danila, M. I., Zhang, J., Bastian, H. M., Reveille, J. D., & Vilá, L. M. (2009) · Arthritis Care & Research · doi:10.1002/art.24538 · Cited by 311 · see citing works
Cervera, R., Khamashta, M. A., Shoenfeld, Y., Camps, M. T., Jacobsen, S., Kiss, E., Zeher, M. M., Tincani, A., Kontopoulou-Griva, I., Galeazzi, M., et al. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.093179 · Cited by 286 · see citing works
Epidemiology of systemic lupus erythematosus
Pons‐Estel, G., Ugarte-Gil, M. F., & Alarcón, G. S. (2017) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2017.1327352 · Cited by 271 · see citing works
Rand, J. H., Wu, X.-X., Quinn, A. S., Ashton, A. W., Chen, P. P., Hathcock, J. J., Andree, H. A. M., & Taatjes, D. J. (2010) · Blood · doi:10.1182/blood-2009-04-213520 · Cited by 253 · see citing works
New concepts in antimalarial use and mode of action in dermatology
Kalia, S., & Dutz, J. P. (2007) · Dermatologic Therapy · doi:10.1111/j.1529-8019.2007.00131.x · Cited by 253 · see citing works
Sacré, K., Criswell, L. A., & McCune, J. M. (2012) · Arthritis Research & Therapy · doi:10.1186/ar3895 · Cited by 243 · see citing works
The role of antimalarial agents in the treatment of SLE and lupus nephritis
Lee, S., Silverman, E. D., & Bargman, J. M. (2011) · Nature Reviews Nephrology · doi:10.1038/nrneph.2011.150 · Cited by 241 · see citing works
Checa, C. M., Zirkzee, E. J. M., Huizinga, T. W. J., & Steup‐Beekman, G. M. (2016) · Drugs · doi:10.1007/s40265-015-0534-3 · Cited by 240 · see citing works
Hydroxychloroquine in systemic lupus erythematosus: overview of current knowledge
Dima, A., Jurcuț, C., Chasset, F., Felten, R., & Arnaud, L. (2022) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x211073001 · Cited by 228 · see citing works
Rempenault, C., Combe, B. G., Barnetche, T., Gaujoux-Viala, C., Lukas, C., Morel, J., & Hua, C. (2017) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2017-211836 · Cited by 221 · see citing works
New insights into mechanisms of therapeutic effects of antimalarial agents in SLE
Wallace, D. J., Gudsoorkar, V. S., Weisman, M. H., & Venuturupalli, S. R. (2012) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2012.106 · Cited by 217 · see citing works
Shinjo, S. K., Bonfá, E., WOJDYLA, D. M., Borba, E. F., Ramírez, L. A., Scherbarth, H. R., Brenol, J. C. T., Chacón-Díaz, R., Neira, O. J., Berbotto, G. A., et al. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27300 · Cited by 208 · see citing works
Petri, M. (2011) · Current Rheumatology Reports · doi:10.1007/s11926-010-0141-y · Cited by 206 · see citing works
Hydroxychloroquine retinopathy — implications of research advances for rheumatology care
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Sciascia, S., Hunt, B. J., Talavera-García, E., Lliso-Ribera, G., Khamashta, M. A., & Cuadrado, M. J. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.09.078 · Cited by 201 · see citing works
Hydroxychloroquine sulfate treatment is associated with later onset of systemic lupus erythematosus
Ja, J., Kim-Howard, X., Bruner, B. F., Jonsson, M., McClain, M. T., Arbuckle, M., Walker, C., Dennis, G., Merrill, J. T., & Harley, J. (2007) · Lupus · doi:10.1177/0961203307078579 · Cited by 197 · see citing works
Hydroxychloroquine: A multifaceted treatment in lupus
Costedoat-Chalumeau, N., Dunogué, B., Morel, N., Guern, V. L., & Guettrot-Imbert, G. (2014) · La Presse Médicale · doi:10.1016/j.lpm.2014.03.007 · Cited by 195 · see citing works
Durcan, L., Clarke, W. A., Magder, L. S., & Petri, M. (2015) · The Journal of Rheumatology · doi:10.3899/jrheum.150379 · Cited by 190 · see citing works
Sisó, A., Ramos-Casals, M., Bové, A., Brito-Zerón, P., Soria, N., Muñoz, S., Testi, A., Plaza, J., Sentís, J., & Coca, A. (2008) · Lupus · doi:10.1177/0961203307086503 · Cited by 189 · see citing works
Willis, R., Seif, A. M., McGwin, G., Martinez-Martinez, L.-A., González, E., Dang, N. N. A., Papalardo, E., LIU, J., Vilá, L., Reveille, J., et al. (2012) · Lupus · doi:10.1177/0961203312437270 · Cited by 189 · see citing works
Atherosclerotic vascular events in a multinational inception cohort of systemic lupus erythematosus
Urowitz, M. B., Gladman, D. D., Ibañez, D., Bae, S., Sanchez-Guerrero, J., Gordon, C., Clarke, A. E., Bernatsky, S., Fortin, P. R., Hanly, J. G., et al. (2010) · Arthritis Care & Research · doi:10.1002/acr.20122 · Cited by 187 · see citing works
Advances in the Medical Treatment of Rheumatoid Arthritis
Kahlenberg, J. M., & Fox, D. A. (2010) · Hand Clinics · doi:10.1016/j.hcl.2010.09.002 · Cited by 174 · see citing works
da Silva, J. C., Mariz, H. D. A., Rocha, L., de Oliveira, P. S. S., Dantas, A. T., Duarte, Â. L. B. P., Pitta, I. D. R., Galdino, S. L., & Pitta, M. G. D. R. (2013) · Clinics · doi:10.6061/clinics/2013(06)07 · Cited by 171 · see citing works
Pharmacology of Chloroquine and Hydroxychloroquine
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Hanly, J. G., Urowitz, M. B., Su, L., Gordon, C., Bae, S., Sánchez‐Guerrero, J., Romero‐Díaz, J., Wallace, D. J., Clarke, A. E., Ginzler, E. M., et al. (2012) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2011-201089 · Cited by 168 · see citing works
Self-citationCohen, H., Cuadrado, M. J., Erkan, D., Duarte‐García, A., Isenberg, D. A., Knight, J. S., Ortel, T. L., Rahman, A., Salmon, J. E., Tektonidou, M. G., et al. (2020) · Lupus · doi:10.1177/0961203320950461 · Cited by 165 · see citing works
Michaud, K. D., Wipfler, K., Shaw, Y., Simon, T. A., Cornish, A., England, B. R., Ogdie, A., & Katz, P. (2020) · ACR Open Rheumatology · doi:10.1002/acr2.11148 · Cited by 164 · see citing works
Quirós-Roldán, E., Biasiotto, G., Magro, P., & Zanella, I. (2020) · Pharmacological Research · doi:10.1016/j.phrs.2020.104904 · Cited by 153 · see citing works
Ruiz‐Irastorza, G., & Bertsias, G. K. (2020) · Rheumatology · doi:10.1093/rheumatology/keaa403 · Cited by 148 · see citing works
Self-citationAkhavan, P. S., Su, J., Lou, W. Y. W., Gladman, D. D., Urowitz, M. B., & Fortin, P. R. (2013) · The Journal of Rheumatology · doi:10.3899/jrheum.120572 · Cited by 147 · see citing works
Chloroquine: Modes of action of an undervalued drug
Thomé, R., Lopes, S. C. P., Costa, F. T. M., & Verinaud, L. M. C. (2013) · Immunology Letters · doi:10.1016/j.imlet.2013.07.004 · Cited by 146 · see citing works
Multifaceted effects of hydroxychloroquine in human disease
Olsen, N. J., Schleich, M. A., & Karp, D. R. (2013) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2013.01.001 · Cited by 146 · see citing works
Hydroxychloroquine Blood Levels Predict Hydroxychloroquine Retinopathy
Petri, M., Elkhalifa, M., Li, J., Magder, L. S., & Goldman, D. W. (2020) · Arthritis & Rheumatology · doi:10.1002/art.41121 · Cited by 143 · see citing works
Rand, J., Xx, W., Quinn, A., & Taatjes, D. J. (2010) · Lupus · doi:10.1177/0961203310361485 · Cited by 143 · see citing works
Determinants of Hydroxychloroquine Blood Concentration Variations in Systemic Lupus Erythematosus
Jallouli, M., Galicier, L., Zahr, N., Aumaître, O., Francès, C., Guern, V. L., Lioté, F., Смаил, А., Limal, N., Pérard, L., et al. (2015) · Arthritis & Rheumatology · doi:10.1002/art.39194 · Cited by 136 · see citing works
An update on mortality in systemic lupus erythematosus.
Ippolito, A., & Petri, M. (2008) · PubMed · Cited by 131 · see citing works
Schreiber, K. I., Breen, K. A., Cohen, H., Jacobsen, S., Middeldorp, S., Pavord, S. R., Regan, L., Roccatello, D., Robinson, S. E., Sciascia, S., et al. (2017) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0037-1603359 · Cited by 128 · see citing works
The non-haemostatic role of platelets in systemic lupus erythematosus
Linge, P., Fortin, P. R., Lood, C., Bengtsson, A. A., & Boilard, É. (2018) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2018.38 · Cited by 125 · see citing works
Nuri, E., Taraborelli, M., Andreoli, L., Tonello, M., Gerosa, M., Calligaro, A., Argolini, L. M., Kumar, R., Pengo, V., Meroni, P. L., et al. (2017) · Immunologic Research · doi:10.1007/s12026-016-8812-z · Cited by 124 · see citing works
A Critical Review of the Effects of Hydroxychloroquine and Chloroquine on the Eye
Costedoat-Chalumeau, N., Dunogué, B., Leroux, G., Morel, N., Jallouli, M., Guern, V. L., Pietté, J. C., Brézin, A. P., Melles, R. B., & Marmor, M. F. (2015) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-015-8469-8 · Cited by 123 · see citing works
Yokogawa, N., Eto, H., Tanikawa, A., Ikeda, T., Yamamoto, K., Takahashi, T., Mizukami, H., Sato, T. Z., Yokota, N., & Furukawa, F. (2016) · Arthritis & Rheumatology · doi:10.1002/art.40018 · Cited by 120 · see citing works
Hydroxychloroquine as an anti-thrombotic in antiphospholipid syndrome
Belizna, C. (2015) · Autoimmunity Reviews · doi:10.1016/j.autrev.2014.12.006 · Cited by 118 · see citing works
Antimalarials may influence the risk of malignancy in systemic lupus erythematosus
Ruiz‐Irastorza, G., Ugarte, A., Egurbide, M.-V., Garmendia, M., Pijoan, J. I., Martínez-Berriotxoa, A., & Aguirre, C. (2007) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2006.067777 · Cited by 118 · see citing works
Self-citationChloroquine and hydroxychloroquine in the treatment of malaria and repurposing in treating COVID-19
Lei, Z., Wu, Z., Dong, S., Yang, D., Zhang, L., Ke, Z., Zou, C., & Chen, Z. (2020) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2020.107672 · Cited by 116 · see citing works
McMahon, M. A., Hahn, B. H., & Skaggs, B. J. (2011) · Expert Review of Clinical Immunology · doi:10.1586/eci.10.98 · Cited by 115 · see citing works
Liu, D., Li, X., Zhang, Y., Kwong, J. S. W., Li, L., Zhang, Y., Xu, C., Li, Q., Sun, X., Tian, H., et al. (2018) · Drug Design Development and Therapy · doi:10.2147/dddt.s166893 · Cited by 114 · see citing works
Kostopoulou, M., Nikolopoulos, D., Parodis, I., & Bertsias, G. K. (2019) · Current Vascular Pharmacology · doi:10.2174/1570161118666191227101636 · Cited by 114 · see citing works
Andrade, R. M., Alarcón, G. S., González, L., Fernández, M., Apte, M., Vilá, L. M., McGwin, G., & Reveille, J. D. (2007) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2007.077594 · Cited by 114 · see citing works
Pragmatic approaches to therapy for systemic lupus erythematosus
Xiong, W., & Lahita, R. G. (2013) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2013.157 · Cited by 113 · see citing works
Kravvariti, E., Koutsogianni, A., Samoli, E., Sfikakis, P. P., & Tektonidou, M. G. (2020) · Autoimmunity Reviews · doi:10.1016/j.autrev.2020.102491 · Cited by 112 · see citing works
Fasano, S., Pierro, L., Pantano, I., Iudici, M., & Valentini, G. (2017) · The Journal of Rheumatology · doi:10.3899/jrheum.161351 · Cited by 110 · see citing works
Koh, J. H., Ko, H. S., Kwok, S.-K., Ju, J. H., & Park, S.-H. (2014) · Lupus · doi:10.1177/0961203314555352 · Cited by 106 · see citing works
BRODER, A., & PUTTERMAN, C. (2013) · The Journal of Rheumatology · doi:10.3899/jrheum.120157 · Cited by 101 · see citing works
“LAC+ and/or at least 1 aPL ≥ 40 U 25 (28) 20 (22) 17 (19) LAC+ and aPL ≥ 40 U 7 (8) 4 (4) 4 (4) LAC– and aPL ≥ 40 U 6 (7) 2 (2) 1 (1) LAC+ and aPL < 40 U 1 (1) 3 (3) 1 (1) LAC unknown and aPL ≥ 40 U 11 (12) 11 (12) 7 (8) LAC unknown and aPL < 40 U 37 (41) 28 (31) 24 (27) At least 1 aPL ≥ 40 U 24 (27) 17 (19) 16 (18) A…”
Almeida-Brasil, C. C., Hanly, J. G., Urowitz, M. B., Clarke, A. E., Ruiz‐Irastorza, G., Gordon, C., Ramsey‐Goldman, R., Petri, M., Ginzler, E. M., Wallace, D. J., et al. (2021) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2021-221295 · Cited by 101 · see citing works
Self-citationCurrent treatment of systemic lupus erythematosus: a clinician's perspective
Pawlak-Buś, K. K., Schmidt, W., Ewa, D., & Leszczyński, P. (2023) · Rheumatology International · doi:10.1007/s00296-023-05306-5 · Cited by 100 · see citing works
Cardiovascular risk factors in primary Sjögren's syndrome: a case-control study in 624 patients
Pérez-De-Lis, M., Akasbi, M., Sisó‐Almirall, A., Díez-Cascón, P., Brito‐Zerón, P., Díaz‐Lagares, C., Ortiz, J., Pérez-Álvarez, R., Ramos‐Casals, M., & Coca, A. (2010) · Lupus · doi:10.1177/0961203310367504 · Cited by 99 · see citing works
Prednisone in lupus nephritis: How much is enough?
Ruiz‐Irastorza, G., Danza, Ã., Perales, I., Villar, I., Garcia, M., Delgado, S., & Khamashta, M. A. (2013) · Autoimmunity Reviews · doi:10.1016/j.autrev.2013.10.013 · Cited by 99 · see citing works
Self-citationAbarientos, C., Sperber, K. E., Shapiro, D. L., Aronow, W. S., Chao, C. P., & Ash, J. Y. (2011) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2011.566555 · Cited by 98 · see citing works
Systemic lupus erythematosus and systemic sclerosis: All roads lead to platelets
Scherlinger, M., Guillotin, V., Truchetet, M., Contin‐Bordes, C., Sisirak, V., Duffau, P., Lazaro, E., Richez, C., & Blanco, P. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.01.012 · Cited by 98 · see citing works
Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain
Sabio, J. M., Zamora‐Pasadas, M., Jiménez‐Jáimez, J., Albadalejo, F., Vargas‐Hitos, J. A., del Águila, M. M. R., Hidalgo-Tenorio, C., González-Gay, M. Á., & Alonso, J. (2008) · Lupus · doi:10.1177/0961203308093554 · Cited by 97 · see citing works
Hydroxychloroquine in lupus: emerging evidence supporting multiple beneficial effects
Tang, C., Godfrey, T., Stawell, R. J., & Nikpour, M. (2012) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2012.02886.x · Cited by 93 · see citing works
Mok, C. C., Penn, H. J., Chan, K. L., Tse, S. M., Langman, L. J., & Jannetto, P. J. (2016) · Arthritis Care & Research · doi:10.1002/acr.22837 · Cited by 93 · see citing works
Immunomodulators in SLE: Clinical evidence and immunologic actions
Durcan, L., & Petri, M. (2016) · Journal of Autoimmunity · doi:10.1016/j.jaut.2016.06.010 · Cited by 92 · see citing works
Bultink, I. E. M., de Vries, F., van Vollenhoven, R., & Lalmohamed, A. (2020) · Rheumatology · doi:10.1093/rheumatology/keaa267 · Cited by 92 · see citing works
Cardiovascular Involvement in Autoimmune Diseases
Amaya‐Amaya, J., Montoya-Sánchez, L., & Rojas‐Villarraga, A. (2014) · BioMed Research International · doi:10.1155/2014/367359 · Cited by 92 · see citing works
Systemic lupus erythematosus risk factors for coronary artery calcifications
Romero‐Díaz, J., Vargas-Vorácková, F., Kimura‐Hayama, E., Cortázar-Benítez, L. F., Gijón-Mitre, R., Críales-Vera, S., Cabiedes, J., Iñiguez-Rodríguez, M. D. R., Lara-Garcia, E. A., Núñez‐Álvarez, C. A., et al. (2011) · Rheumatology · doi:10.1093/rheumatology/ker307 · Cited by 91 · see citing works
Castrejón, I., Tani, C., Jolly, M., Huang, A., & Mosca, M. (2014) · PubMed · Cited by 89 · see citing works
Neto, E. T. D. R., Kakehasi, A. M., Pinheiro, M. A. A., Ferreira, G. A., Marques, C. D. L., da Mota, L. M. H., Paiva, E. D. S., Pileggi, G. S., Sato, E. I., Gomides, A. P. M., et al. (2020) · Revista Brasileira de Reumatologia · doi:10.1186/s42358-020-00134-8 · Cited by 88 · see citing works
Urowitz, M. B., Ohsfeldt, R. L., Wielage, R. C., Kelton, K. A., Asukai, Y., & Ramachandran, S. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2018-214043 · Cited by 88 · see citing works
Atherosclerosis in Systemic Lupus Erythematosus
Stojan, G., & Petri, M. (2013) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0b013e31829dd857 · Cited by 85 · see citing works
Towards new avenues in the management of lupus glomerulonephritis
Mok, C. C. (2016) · Nature Reviews Rheumatology · doi:10.1038/nrrheum.2015.174 · Cited by 84 · see citing works
Floris, A., Piga, M., Mangoni, A. A., Bortoluzzi, A., Erre, G. L., & Cauli, A. (2018) · Mediators of Inflammation · doi:10.1155/2018/3424136 · Cited by 83 · see citing works
Lupus in Latin-American patients: lessons from the GLADEL cohort
Pons‐Estel, G., Catoggio, L. J., Cardiel, M. H., Bonfá, E., Caeiro, F., Sato, E. I., Massardo, L., Molina, J. F., Toledano, M. G., Barile-Fabris, L. A., et al. (2015) · Lupus · doi:10.1177/0961203314567753 · Cited by 81 · see citing works
Venous Thrombosis in the Antiphospholipid Syndrome
Farmer-Boatwright, M. K., & Roubey, R. A. S. (2009) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.108.182204 · Cited by 79 · see citing works
Glucocorticoids and antimalarials in systemic lupus erythematosus: an update and future directions
Ugarte, A., Danza, Ã., & Ruiz‐Irastorza, G. (2018) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000527 · Cited by 79 · see citing works
Self-citationCurrent and emerging treatment options in the management of lupus
Jordan, N., & D’Cruz, D. P. (2016) · ImmunoTargets and Therapy · doi:10.2147/itt.s40675 · Cited by 78 · see citing works
Belizna, C. C., Pregnolato, F., Abad, S., Alijotas‐Reig, J., Amital, H., Amoura, Z., Andréoli, L., Andrès, E., Aouba, A., Bilgen, Ş. A., et al. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.05.012 · Cited by 78 · see citing works
Sciascia, S., Branch, D. W., Levy, R. A., Middeldorp, S., Pavord, S. R., Roccatello, D., Ruiz‐Irastorza, G., Tincani, A., Khamashta, M. A., Schreiber, K. I., et al. (2015) · Thrombosis and Haemostasis · doi:10.1160/th15-06-0491 · Cited by 78 · see citing works
Self-citationManagement of antiphospholipid syndrome
Tuthill, J. I., & Khamashta, M. A. (2009) · Journal of Autoimmunity · doi:10.1016/j.jaut.2009.05.002 · Cited by 78 · see citing works
TLR9 Blockade Inhibits Activation of Diabetogenic CD8+ T Cells and Delays Autoimmune Diabetes
Zhang, Y., Lee, A. S., Shameli, A., Geng, X., Finegood, D. T., Santamaría, P., & Dutz, J. P. (2010) · The Journal of Immunology · doi:10.4049/jimmunol.0901814 · Cited by 78 · see citing works
Martinez-Berriotxoa, A., Ruiz-Irastorza, G., Egurbide, M.-V., Garmendia, M., Gabriel Erdozain, J., Villar, I., & Aguirre, C. (2007) · Lupus · doi:10.1177/0961203307083316 · Cited by 77 · see citing works
Self-citationMok, C. C., Tse, S. M., Chan, K. L., & Ho, L. Y. (2017) · Lupus · doi:10.1177/0961203317739129 · Cited by 76 · see citing works
Hydroxychloroquine: the cornerstone of lupus therapy
Ruiz‐Irastorza, G., & Khamashta, M. A. (2008) · Lupus · doi:10.1177/0961203307086643 · Cited by 76 · see citing works
Self-citationAntiphospohlipid syndrome in obstetrics
Danza, Ã., Ruiz‐Irastorza, G., & Khamashta, M. A. (2011) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2011.10.006 · Cited by 74 · see citing works
Self-citationGuidelines on the investigation and management of antiphospholipid syndrome
Arachchillage, D. J., Platton, S., Hickey, K. P., Chu, J., Pickering, M. C., Sommerville, P., MacCallum, P., & Breen, K. A. (2024) · British Journal of Haematology · doi:10.1111/bjh.19635 · Cited by 74 · see citing works
- Authors
- Ruiz-Irastorza, G., Egurbide, M.-V., Pijoan, J.-I., Garmendia, M., Villar, I., Martinez-Berriotxoa, A., Erdozain, J.-G., & Aguirre, C.
- Affiliations
- Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain,
- University of the Basque Country (ES)
- Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2006-09
- Volume
- 15
- Issue
- 9
- Pages
- 577-583
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- OpenAlex
- W2014873778
- Cited by
- 411
- References
- 48
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 30 · 2023: 24 · 2022: 19 · 2021: 22 · 2020: 29 · 2019: 23 · 2018: 27 · 2017: 17 · 2016: 18 · 2015: 20 · 2014: 28 · 2013: 22 · 2012: 25
- FWCI
- 11.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lupus (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- antimalarial drugs, systemic lupus erythematosus, thrombosis, survival, antiphospholipid antibodies, cardiovascular complications, mortality, hydroxychloroquine, chloroquine
- MeSH terms
- Adult, Analysis of Variance, Antimalarials, Cause of Death, Female, Follow-Up Studies, Humans, Lupus Erythematosus, Systemic, Male, Middle Aged, Prospective Studies, Research Design, Risk Factors, Spain, Thrombosis, Time Factors, Survival Rate, Proportional Hazards Models, Survival Analysis, Treatment Failure, Endpoint Determination
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