title: Hydroxychloroquine in systemic lupus erythematosus (SLE).
abstract: Hydroxychloroquine (HCQ) is an alkalinizing lysosomatropic drug that accumulates in lysosomes where it inhibits some important functions by increasing the pH. HCQ has proved to be effective in a number of autoimmune diseases including systemic lupus erythematosus (SLE). Areas covered: In this review the mechanisms of action, the efficacy, and the safety of HCQ in the management of patients with SLE have been reviewed. HCQ may reduce the risk of flares, allow the reduction of the dosage of steroids, reduce organ damage, and prevent the thrombotic effects of anti-phospholipid antibodies. The drug is generally safe and may be prescribed to pregnant women. However, some cautions are needed to prevent retinopathy, a rare but serious complication of the prolonged use of HCQ. Expert opinion: HCQ may offer several advantages not only in patients with mild SLE but can also exert important beneficial effects in lupus patients with organ involvement and in pregnant women. The drug has a low cost and few side effects. These characteristics should encourage a larger use of HCQ, also in lupus patients with organ involvement.
authors.affiliation: a Nephrological Unit , Humanitas Clinical and Research Center , Rozzano (Milano) , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ponticelli
authors.affiliation: b Nephrological Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Moroni
mesh_terms: D000818:Animals; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D012164:Retinal Diseases / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine
keywords: Systemic lupus erythematosus; antimalarial agents; cutaneous lupus; hydroxychloroquine; lupus flares; lupus nephritis; retinopathy