In a nutshell
This study investigated if hydroxychloroquine (HCQ; Plaquenil) is an effective treatment in rheumatoid arthritis (RA).
They found that combining HCQ with other RA drugs improves symptoms.
Some background
Rheumatoid arthritis (RA) is a long-term condition. It is caused by excessive inflammation in the joints. This leads to painful swelling and disability. RA is treated with drugs to reduce inflammation. They are called disease-modifying anti-rheumatic drugs (DMARDs). Hydroxychloroquine (HCQ) is a drug used to treat RA. It can reduce inflammation in several ways. It is commonly used to treat diseases where there is systemic (whole body) inflammation. It may protect against organ damage and bone mass loss.
HCQ has been used in RA treatment for many years. However, more effective RA drugs have been developed. HCQ may still be useful in RA. The protective benefits to the bone and cardiovascular (heart and circulation) system are important for patients with RA. However, it is not clear if it is effective as a stand-alone treatment (monotherapy, MT).
Methods & findings
This study reviewed published reports on HCQ use in RA. This analysis included 11 studies with 8428 patients. The effectiveness of HCQ was compared to a number of RA drugs. HCQ was evaluated as a MT compared to other drugs. It was also analyzed in combination treatment.
Most patients treated with HCQ MT had early RA and no previous DMARD treatment. Compared to MT with methotrexate (MTX), HCQ was not as effective. Compared to sulfasalazine (SSZ) MT there was no significant difference in clinical symptoms between the groups.
However, HCQ in combination with MTX was more effective than MTX alone in 2 studies. In a study with HCQ in combination with SSZ, there was no difference compared to SSZ alone. In a triple combination study, HCQ in combination with MTX and SSZ was more effective than MTX and SSZ. The safety profile in these studies was similar between the treatment groups.
The bottom line
The authors concluded that combining HCQ with other RA drugs improves symptoms.
The fine print
Some of the studies included in the analysis were not random controlled trials (RCTs). This means that patients were deliberately given certain medications. This makes it more difficult to determine if HCQ is beneficial to all patients.
What’s next?
If you have any concerns regarding RA treatment, please consult with your physician.
Published By :
Arthritis Care & Research
Date :
Jan 10, 2019
