BACKGROUND AND OBJECTIVES: Hydroxychloroquine is widely used in patients with rheumatoid arthritis. However, large-scale studies examining the long-term effects of hydroxychloroquine on the development of kidney disease in patients with rheumatoid arthritis are lacking. We aimed to assess the long-term association of hydroxychloroquine use with the risk of developing CKD in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an observational cohort study for patients with newly diagnosed rheumatoid arthritis who were enrolled prospectively in Taiwan's National Health Insurance Research Database between January 1, 2000 and December 31, 2013. We used multivariable Cox proportional hazard regression to analyze the association of hydroxychloroquine use with incident CKD. RESULTS: A total of 2619 patients, including 1212 hydroxychloroquine users and 1407 hydroxychloroquine nonusers, were analyzed. Incident CKD was reported in 48 of 1212 hydroxychloroquine users and 121 of 1407 hydroxychloroquine nonusers. The incidence rate of CKD was lower in hydroxychloroquine users than in hydroxychloroquine nonusers (10.3 versus 13.8 per 1000 person-years). After multivariable adjustment, hydroxychloroquine users still had a lower risk of incident CKD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.45 to 0.90; P=0.01) than hydroxychloroquine nonusers. The lower risk of subsequent CKD development was dose dependent and consistent across subgroup analyses. CONCLUSIONS: Hydroxychloroquine use in patients with newly diagnosed rheumatoid arthritis is associated with a significantly lower risk of incident CKD compared with in nonusers.
BACKGROUND AND OBJECTIVES:Hydroxychloroquine is widely used in patients with rheumatoid arthritis. However, large-scale studies examining the long-term effects of hydroxychloroquine on the development of kidney disease in patients with rheumatoid arthritis are lacking. We aimed to assess the long-term association of hydroxychloroquine use with the risk of developing CKD in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted an observational cohort study for patients with newly diagnosed rheumatoid arthritis who were enrolled prospectively in Taiwan's National Health Insurance Research Database between January 1, 2000 and December 31, 2013. We used multivariable Cox proportional hazard regression to analyze the association of hydroxychloroquine use with incident CKD. RESULTS: A total of 2619 patients, including 1212 hydroxychloroquine users and 1407 hydroxychloroquine nonusers, were analyzed. Incident CKD was reported in 48 of 1212 hydroxychloroquine users and 121 of 1407 hydroxychloroquine nonusers. The incidence rate of CKD was lower in hydroxychloroquine users than in hydroxychloroquine nonusers (10.3 versus 13.8 per 1000 person-years). After multivariable adjustment, hydroxychloroquine users still had a lower risk of incident CKD (adjusted hazard ratio, 0.64; 95% confidence interval, 0.45 to 0.90; P=0.01) than hydroxychloroquine nonusers. The lower risk of subsequent CKD development was dose dependent and consistent across subgroup analyses. CONCLUSIONS:Hydroxychloroquine use in patients with newly diagnosed rheumatoid arthritis is associated with a significantly lower risk of incident CKD compared with in nonusers.
Authors: R W Berliner; D P Earle; J V Taggart; C G Zubrod; W J Welch; N J Conan; E Bauman; S T Scudder; J A Shannon Journal: J Clin Invest Date: 1948-05 Impact factor: 14.808
Authors: Elizabeth F O Kern; Miriam Maney; Donald R Miller; Chin-Lin Tseng; Anjali Tiwari; Mangala Rajan; David Aron; Leonard Pogach Journal: Health Serv Res Date: 2006-04 Impact factor: 3.402
Authors: Laurence Beck; Andrew S Bomback; Michael J Choi; Larry B Holzman; Carol Langford; Laura H Mariani; Michael J Somers; Howard Trachtman; Meryl Waldman Journal: Am J Kidney Dis Date: 2013-07-18 Impact factor: 8.860
Authors: S Karie; F Gandjbakhch; N Janus; V Launay-Vacher; S Rozenberg; C U Mai Ba; P Bourgeois; G Deray Journal: Rheumatology (Oxford) Date: 2008-01-31 Impact factor: 7.580
Authors: Gerwyn Morris; Eugene Athan; Ken Walder; Chiara C Bortolasci; Adrienne O'Neil; Wolf Marx; Michael Berk; André F Carvalho; Michael Maes; Basant K Puri Journal: Life Sci Date: 2020-10-06 Impact factor: 6.780