title: Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients.
abstract: OBJECTIVE
  Cardiovascular disease (CVD) is the leading cause of death in patients with rheumatoid arthritis (RA). Disease-modifying therapies that improve risk factors for CVD, such as dyslipidemia, are desired. This study used an electronic health record to determine if hydroxychloroquine (HCQ) use was associated with an improvement in lipid levels in an inception RA cohort.
  
  
  METHODS
  All adult individuals with the initial diagnosis of RA between January 1, 2001, and March 31, 2008, were identified (n=1,539). Only patients with at least one lipid level post-RA diagnosis were included (n=706). Information on demographics, medical history, body mass index (BMI), laboratory measures, and medications were collected at office visits. Potential risk and protective factors for dyslipidemia were controlled for in linear mixed-effects regression models for low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, triglycerides, LDL/HDL, and total cholesterol/HDL.
  
  
  RESULTS
  Patients were 69% women and 98% white, with a median age of 65 years and a median BMI of 29.8 kg/m2. In the adjusted regression models, HCQ use was associated with the following average differences in lipids: LDL decrease of 7.55 mg/dl (P<0.001), HDL increase of 1.02 mg/dl (P=0.20), total cholesterol decrease of 7.70 mg/dl (P=0.002), triglycerides decrease of 10.91 mg/dl (P=0.06), LDL/HDL decrease of 0.136 (P=0.008), and total cholesterol/HDL decrease of 0.191 (P=0.006), which were stable over time.
  
  
  CONCLUSIONS
  Use of HCQ in this RA cohort was independently associated with a significant decrease in LDL, total cholesterol, LDL/HDL, and total cholesterol/HDL. Considering these results, its safety profile, and low cost, HCQ remains a valuable initial or adjunct therapy in this patient population at high risk for CVD.
authors: Geisinger Health System, Danville, Pennsylvania 17822, USA.
authors: Stephanie J
authors: SJ
authors: Morris
authors: Mary Chester M
authors: MC
authors: Wasko
authors: Jana L
authors: JL
authors: Antohe
authors: Jennifer A
authors: JA
authors: Sartorius
authors: H Lester
authors: HL
authors: Kirchner
authors: Sorina
authors: S
authors: Dancea
authors: Androniki
authors: A
authors: Bili
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D002784:Cholesterol / Q000096:biosynthesis / Q000097:blood; D008076:Cholesterol, HDL / Q000096:biosynthesis / Q000097:blood; D008078:Cholesterol, LDL / Q000096:biosynthesis / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006886:Hydroxychloroquine; D002784:Cholesterol