Rempenault C, et al. - The available literature on the cardiovascular effect of Hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA) is systematically reviewed. Besides its limited effectiveness for disease activity and progression, HCQ may benefit the metabolic profile and to a lesser extent cardiovascular events in patients with RA, which recommends its usefulness combined with other conventional synthetic disease-modifying antirheumatic drugs.

Methods

• In this study, they systematically searched for studies assessing the impacts of HCQ on cardiovascular outcomes of known risk factors for CVD in patients with RA.
• The MEDLINE (via PubMed), EMBase, Cochrane Library and the American College of Rheumatology and European League Against Rheumatism annual meetings databases were searched in this study.
• A meta-analysis was performed with a random-effects model, evaluating mean differences (MDs), HRs and 95% CIs.
• Information was extricated by one examiner and independently checked by another.

Results

• Total 185 articles and abstracts of interest were uncovered in this literature search.
• Further examination resulted in 16 studies fulfilling the criteria.
• The MDs between HCQ users and non-users in levels of total, low-density and high-density cholesterol and triglycerides were -9.8 (95% CI -14.0 to -5.6), -10.6 (95% CI -14.2 to -7.0), +4.1 (95% CI 2.2 to 6.0) and -19.2 (95% CI -27.2 to -11.1), respectively.
• Diabetes incidence was lower for HCQ ever users than never users (HR 0.59 (95% CI 0.49 to 0.70)).
• HCQ appeared to reduce insulin resistance and incidence of CVD.
• However data were too few for meta-analysis.