The antimalarials, hydroxychloroquine, and chloroquine are used for musculoskeletal and cutaneous features of Systemic Lupus Erythematosus (SLE) but have additional benefits including prevention of disease flares¹. Hydroxychloroquine reduces risk of damage accrual in SLE including renal damage. In addition, a beneficial effect on patient survival has been demonstrated as well as a positive effect on lipid profiles with significant reductions in total cholesterol, low density lipoprotein, and triglycerides². Hydroxychloroquine may reduce cardiovascular and thrombotic risk in SLE patients.
It is generally accepted that therapy with an antimalarial should be part of SLE therapy. During the period 2017-2021, in 2595 unique SLE patients, 86.5% were on either chloroquine or hydroxychloroquine. A chart review of those not on the medication showed the reasons for not being on this treatment included side effects (eye toxicity, GI side effects), patient refusal, and long-term remission with drug discontinuation.
¹Ponticelli C, Moroni G. Hydroxychloroquine in systemic lupus erythematosus (SLE). Expert Opin Drug Saf. 2017 Mar;16(3):411-419.
²Costedoat-Chalumeau N, Dunogué B, Morel N, Le Guern V, Guettrot-Imbert G. Hydroxychloroquine: a multifaceted treatment in lupus. Presse Med. 2014 Jun;43(6 Pt 2):e167-80.