Prevention of Postoperative Deep Venous Thrombosis in Legs by Orally administered Hydroxychloroquine Sulphate

Carter, A. E.; Eban, R.

doi:10.1136/bmj.3.5923.94

Cited by 81 publications

(46 citation statements)

References 3 publications

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“…This hypothesis is raised because of previous reports indicating that leukopenia is associated with atherosclerosis in SS (1) and that lymphopenia is associated with atherosclerosis in SLE (2). Their study also reveals that anti-SSA antibodies are a risk factor for the progression of atherosclerosis, and data from SLE studies showed that lymphopenia is highly associated with the presence of anti-SSA antibodies (3).…”

Section: To the Editormentioning

confidence: 92%

“…We did not state in our article that the issue of the thromboprotective effects of antimalarials had only been addressed in studies involving populations without SLE but were instead referring to the findings of 2 prospective studies in non-SLE populations (1,2). We referred to other descriptive and observational studies in SLE, and acknowledge that we did not refer to all available publications on this topic and that Wallace has previously questioned whether hydroxychloroquine prevented clot formation in SLE and showed a protective association between use of hydroxychloroquine and thrombosis in 92 patients with SLE (3).…”

Section: To the Editormentioning

confidence: 99%

“…In the recent article by Klaasen et al (1), the authors reanalyze synovial biopsy samples from a previously reported study in which they had concluded that synovial lymphoid neogenesis does not define a specific clinical rheumatoid arthritis (RA) phenotype (2). They conclude that lymphoid aggregation predicts better response (according to the criteria determined by the European League Against Rheumatism [EULAR]) (3) to anti-tumor necrosis factor (anti-TNF) (1).…”

Section: To the Editormentioning

confidence: 99%

“…They conclude that lymphoid aggregation predicts better response (according to the criteria determined by the European League Against Rheumatism [EULAR]) (3) to anti-tumor necrosis factor (anti-TNF) (1). While the first study analyzed lymphoid neogenesis defined as large (grade 2 or 3) T cell aggregates, the second focuses on aggregates regardless of their size.…”

Section: To the Editormentioning

confidence: 99%

“…Klaasen and colleagues identify the presence of lymphocyte aggregates on anti-CD3-stained sections, regardless of B cell aggregation, and define grade 1 aggregates as those with 1-5 cells in the radius (1). The high number of patients lacking aggregates in their cohort (43%) is surprising, given such a small cell-aggregation radius.…”

Section: To the Editormentioning

confidence: 99%

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Fortin¹,

Jung²,

Lou³

2010

Arthritis & Rheumatism

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Section: To the Editormentioning

confidence: 92%

Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

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Fortin¹,

Jung²,

Lou³

2010

Arthritis & Rheumatism

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Does hydroxychloroquine sulfate prevent clot formation in systemic lupus erythematosus?

Wallace

1987

Arthritis & Rheumatism

119

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The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus

Jung

Bobba

et al. 2010

Arthritis & Rheumatism

264

134

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Objective. The antimalarial medication hydroxychloroquine has been proposed as a thromboprotective agent in systemic lupus erythematosus (SLE), but studies thus far have been limited by the possibility of confounding by indication. This study was conducted to assess whether exposure to antimalarial drugs is associated with a decrease in thrombovascular events (TEs) in patients with SLE.Methods. The study was designed as a nested case-control study embedded in an inception cohort of patients with SLE, which allowed adjustments for possible confounding by calendar year, duration of disease, duration of observation, and severity of lupus. After controlling for the possible confounding variables in conditional logistic regression models, the use of antimalarial drugs was assessed for its effects on the development of TEs in lupus patients.Results. Fifty-four cases of TE were identified, and these were matched with 108 control subjects (lupus patients without TEs). Univariate analyses identified older age (odds ratio [OR] 1.04, 95% confidence interval [95%CI] 1.01-1.07) or being older than age 50 years (OR 3.5, 95% CI 1.4-8.6) and ever having hypertension (OR 2.5, 95% CI 1.0-5.8) as being associated with an increased risk of TEs, whereas use of antimalarial drugs (OR 0.31, 95% CI 0.13-0.71) was associated with a decreased risk of TEs. Separate analyses were done for arterial and venous TEs, which yielded similar results. In multivariate analyses, use of antimalarial drugs (OR 0.32, 95% CI 0.14-0.74) and older age (OR 1.04, 95% CI 1.01-1.07) were the only 2 variables that remained significant.Conclusion. The results from this nested casecontrol study demonstrate that, after accounting for the effects of disease severity, disease duration, and calendar year, antimalarial drugs were found to be thromboprotective, being associated with a 68% reduction in the risk of all TEs, with a range of risk reduction of at least 26% up to as high as 86%.Systemic lupus erythematosus (SLE) is a systemic illness of autoimmune etiology, characterized by either acute or chronic inflammation of multiple organs. The prevalence of SLE in North America is ϳ40 per 100,000 people (1,2), and more than 80% of cases occur in women who develop the illness during their childbearing years. As a consequence, the disease may affect as many as 1 in 1,000 young women. The risk of arterial, venous, or small-vessel thrombovascular events (TEs) in a patient with SLE is significantly higher than that in the

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Prevention of Postoperative Deep Venous Thrombosis in Legs by Orally administered Hydroxychloroquine Sulphate

Cited by 81 publications

References 3 publications

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Does hydroxychloroquine sulfate prevent clot formation in systemic lupus erythematosus?

The protective effect of antimalarial drugs on thrombovascular events in systemic lupus erythematosus

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