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Use of hydroxychloroquine and risk of major adverse cardiovascular events in patients with lupus erythematosus: A Danish nationwide cohort study.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2021 Apr; Vol. 84 (4), pp. 930-937. Date of Electronic Publication: 2020 Dec 13. - Publication Year :
- 2021
-
Abstract
- Background: Limited data suggest that hydroxychloroquine may affect risk of cardiovascular disease in patients with lupus erythematosus (LE).<br />Objective: To investigate whether hydroxychloroquine treatment is associated with major adverse cardiovascular events (MACE) (myocardial infarction, ischemic stroke, or cardiovascular-associated death) in patients with cutaneous LE (CLE) or systemic LE (SLE).<br />Methods: Based on the Danish nationwide registers, an observational cohort study was conducted including patients with first-time diagnosis of CLE or SLE (between 1997 and 2017). Cox regression models calculating the hazard ratio (HR) analyzing the risk of MACE were performed comparing time on and off hydroxychloroquine (including never users). The models were adjusted for age, sex, socioeconomic status, concomitant treatment, and cardiovascular risk factors.<br />Results: Among 4587 patients with LE, 51% (n = 2343) were treated with hydroxychloroquine during the study period. An inverse association between use of hydroxychloroquine and MACE risk was observed among patients with SLE (adjusted HR, 0.65; 95% confidence interval, 0.46-0.90) and patients with CLE (adjusted HR, 0.71; 95% confidence interval, 0.42-1.19). Consistent results were found in sensitivity analyses including a case-time control design.<br />Limitations: No information on disease activity/severity was available.<br />Conclusion: Our findings indicate an opportunity to reduce the risk of cardiovascular events in patients with LE through use of hydroxychloroquine.<br />Competing Interests: Conflicts of interest Dr Kofoed reports personal fees from Eli Lilly, AbbVie, Leo Pharma, Bristol Meyers Squibb, Galderma, and Takeda Pharma during the conduct of the study. Dr Egeberg reports grants and personal fees from Pfizer, grants and personal fees from Eli Lilly, grants from Danish National Psoriasis Foundation, grants from Kgl Hofbundtmager Aage Bang Foundation, grants and personal fees from AbbVie, personal fees from Bristol Meyers Squibb, personal fees from Leo Pharma, personal fees from Samsung Bioepis Co Ltd, grants and personal fees from Novartis, personal fees from Galderma, and personal fees from Janssen Pharmaceuticals during the conduct of the study. Drs Haugaard and Dreyer, Author Ottosen, and Dr Gislason have no conflicts of interest to declare.<br /> (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Brain Ischemia chemically induced
Cohort Studies
Comorbidity
Confounding Factors, Epidemiologic
Denmark epidemiology
Diabetes Mellitus epidemiology
Female
Humans
Hydroxychloroquine therapeutic use
Hypercholesterolemia epidemiology
Hypertension epidemiology
Incidence
Income
Lupus Erythematosus, Cutaneous epidemiology
Lupus Erythematosus, Systemic epidemiology
Male
Middle Aged
Myocardial Infarction chemically induced
Proportional Hazards Models
Registries
Risk
Smoking epidemiology
Smoking Cessation statistics & numerical data
Social Class
Brain Ischemia epidemiology
Cardiovascular Diseases mortality
Hydroxychloroquine adverse effects
Lupus Erythematosus, Cutaneous drug therapy
Lupus Erythematosus, Systemic drug therapy
Myocardial Infarction epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 84
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 33321159
- Full Text :
- https://doi.org/10.1016/j.jaad.2020.12.013