Antimalarials in the management of discoid and systemic lupus erythematosus

Pharmacology of Chloroquine and Hydroxychloroquine

“…In RA and SLE it is commonly observed that 60-95 % of patients taking chloroquine have a clinical response measured by subjective improvement, objective responses in laboratory measurements, activities of daily living, and reductions in fl ares of disease [ 8 , 10 , 37 , 71 , 106 -112 ]. Although initially embraced for 45 Mackenzie [ 80 ] patients with milder forms of SLE and RA [ 10 ], the recent trend is that 4AQs are being used in a higher proportion of patients with SLE; some have advocated their use in all SLE patients [ 24 , 104 ]. Many reports pool all patients taking 4AQs together under the assumption that the disease for which the drug is taken is immaterial to the risk of retinopathy [ 62 , 113 , 114 ].…”

Hydroxychloroquine and smoking in patients with cutaneous lupus erythematosus

“…68 The study found that 70% of participants smoked at least one cigarette per day, and smoking was associated with poorer past week and 3-month medication adherence. 3 In a study of HIV-positive men and women (n = 64), current cigarette smoking, lower CD4 counts and lower educational status emerged as independent predictors of poorer adherence among patients on HAART. 69 …”

“…2 Since antimalarials first became widely used for LE in the 1950s, they have remained the first-line therapeutic agents, with response rates as high as 75-95% in the treatment of CLE. 3 Although controlled studies comparing the efficacy of antimalarials (such as chloroquine and hydroxychloroquine) vs. placebo and other treatments are generally lacking, many case reports and series support the therapeutic efficacy of these agents in treating both LE-specific and LE-nonspecific skin lesions.…”

Hydroxychloroquine: past, present, future

“…Past experience with antimalarials suggested that they improved rash and arthritis, 12 and possibly serositis, 13 but, did not bene®t major organ involvement. A retrospective study of outcome in 43 SLE patients who stopped antimalarials showed that the antimalarial family' (HCQ, chloroquine, and quinacrine) reduced disease¯ares and was corticosteroid sparing.…”