Babary H, et al. - The clinicians explored the effects of hydroxychloroquine (HCQ) on serum low-density lipoprotein (LDL) level in patients with systemic lupus erythematosus (SLE). They disclosed that in these patients HCQ was associated with serum LDL level reduction by mean 24.397 mg/dL. However, future prospective studies were required to fully characterize the treatment effect.

Methods

• A systematic search of 7 major literature search databases from their inception until 3 April, 2017 identified nine studies.
• Random-effects pooled mean difference with corresponding 95% confidence intervals (CI) was estimated.
• Heterogeneity was measured by I².
• By visual inspection of funnel plots, publication bias was evaluated.
• Sensitivity analysis examined whether HCQ effect on serum total cholesterol level was similar to the main analysis.
• The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the overall quality of evidence.

Results

• This study consisted of 559 patients from eight observation studies (two before-after studies; six case-control studies) examining the effects of HCQ on serum LDL.
• Pooled study participants' characteristics were as follows: mean age 45.719, female 95.262%, and prednisone use 58.366%.
• HCQ reduced mean LDL levels by 24.397 mg/dL (95% CI 8.921–39.872; P = 0.002).
• The number of studies identifying statin use was too few to perform meta-regression analysis of statin use.
• Heterogeneity was extensive (I² = 94.739%).
• Symmetrical funnel plot visualized no evidence of publication bias.