Hydroxychloroquine and glycemia in women with rheumatoid arthritis and systemic lupus erythematosus.
OBJECTIVE
To determine the relationship between current hydroxychloroquine (HCQ) use and 2 indicators of glycemic control, fasting glucose and insulin sensitivity, in nondiabetic women with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA).


METHODS
Nondiabetic women with SLE (n = 149) or RA (n = 177) recruited between 2000 and 2005 for a cross-sectional evaluation of cardiovascular risk factors were characterized by HCQ usage status. Unadjusted and multivariately adjusted mean fasting glucose, median insulin, and insulin resistance [assessed by the homeostasis model assessment (HOMA-IR) calculation] were compared among HCQ users and nonusers for disease-specific groups.


RESULTS
More women with SLE were taking HCQ than those with RA (48% vs 18%; p < 0.0001; mean dose ~ 400 mg vs ~ 200 mg). For women with SLE or RA, after adjustment for age, waist circumference, disease duration, prednisone dosage, C-reactive protein, menopausal status, nonsteroidal antiinflammatory drugs, and disease-specific indicators, serum glucose was lower in HCQ users than in nonusers (SLE: 85.9 vs 89.3 mg/dl, p = 0.04; RA: 82.5 vs 86.6 mg/dl, p = 0.05). In women with SLE, HCQ use also was associated with lower (log)HOMA-IR (0.97 vs 1.12, p = 0.09); in those with RA, no differences in (log)HOMA-IR were seen. HCQ usage was not associated with fasting insulin levels in either patient group.


CONCLUSIONS
HCQ use was associated with lower fasting glucose in women with SLE or RA and also lower (log)HOMA-IR in the SLE group. The use of HCQ may be beneficial for reducing cardiovascular risk by improving glycemic control in these patients.
Penn
Sara Kaprove
SK
Department of Medicine, Division of Rheumatology, University of Pittsburgh, School of Nursing, 440 Victoria Street, Room 453B, Pittsburgh, PA 15261, USA.
Kao
Amy H
AH
Schott
Laura L
LL
Elliott
Jennifer R
JR
Toledo
Frederico G S
FG
Kuller
Lewis
L
Manzi
Susan
S
Wasko
Mary Chester M
MC
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D001786:Blood Glucose / Q000187:drug effects; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D038321:Glycemic Index / Q000187:drug effects; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced*; D007328:Insulin / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D024821:Metabolic Syndrome / Q000517:prevention & control; D008875:Middle Aged; D017698:Postmenopause; D011241:Prednisone / Q000627:therapeutic use
D018501:Antirheumatic Agents; D001786:Blood Glucose; D007328:Insulin; D006886:Hydroxychloroquine; D011241:Prednisone