April Jorge1, Na Lu1,2, Hyon Choi1, John M Esdaile2,3, Diane Lacaille2,3, J Antonio Avina-Zubieta2,3. 1. Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital. 2. Arthritis Research Canada, Richmond, BC, Canada. 3. Divison of Rheumatology, University of British Columbia, Vancouver, BC, Canada.
Abstract
OBJECTIVE: We evaluated the potential temporal association between Hydroxychloroquine (HCQ) use and cardiovascular (CV) events among patients with SLE or RA. METHODS: We conducted a nested case-control study within inception cohorts of SLE and RA patients using administrative health databases including the entire population of British Columbia, Canada. We identified cases with incident CV events, including myocardial infarction (MI), stroke, or venous thromboembolism (VTE). We matched each case with up to three controls on age, sex, and rheumatic disease. HCQ exposure was categorized by the time between the last HCQ prescription date covered and the index date as current use, recent use, remote use, or never used. We used conditional logistic regression to assess the association between HCQ exposure and CV events, using remote use as the reference group. RESULTS: We identified 10,268 cases and 29,969 controls. Adjusted conditional odd ratios (cORs) (95% CI) for current HCQ use relative to remote use were 0.86 (0.77-0.97) for combined CV events, 0.88 (0.74, 1.05) for MI, 0.87 (0.74, 1.03) for stroke, and 0.74 (0.59, 0.94) for VTE. Recent HCQ users and non-users had similar odds of combined CV events as remote users (cORs 0.93 ([95% CI, 0.77-1.13] and 0.96 [95% CI, 0.88-1.04], respectively). CONCLUSION: In this nested case-control study of patents with SLE and RA, we found a reduced risk of overall CV events associated with current HCQ use including reductions in VTE and trends towards reductions in MI and stroke. These findings suggest a possible cardiovascular preventative benefit of HCQ use. This article is protected by copyright. All rights reserved.
OBJECTIVE: We evaluated the potential temporal association between Hydroxychloroquine (HCQ) use and cardiovascular (CV) events among patients with SLE or RA. METHODS: We conducted a nested case-control study within inception cohorts of SLE and RA patients using administrative health databases including the entire population of British Columbia, Canada. We identified cases with incident CV events, including myocardial infarction (MI), stroke, or venous thromboembolism (VTE). We matched each case with up to three controls on age, sex, and rheumatic disease. HCQ exposure was categorized by the time between the last HCQ prescription date covered and the index date as current use, recent use, remote use, or never used. We used conditional logistic regression to assess the association between HCQ exposure and CV events, using remote use as the reference group. RESULTS: We identified 10,268 cases and 29,969 controls. Adjusted conditional odd ratios (cORs) (95% CI) for current HCQ use relative to remote use were 0.86 (0.77-0.97) for combined CV events, 0.88 (0.74, 1.05) for MI, 0.87 (0.74, 1.03) for stroke, and 0.74 (0.59, 0.94) for VTE. Recent HCQ users and non-users had similar odds of combined CV events as remote users (cORs 0.93 ([95% CI, 0.77-1.13] and 0.96 [95% CI, 0.88-1.04], respectively). CONCLUSION: In this nested case-control study of patents with SLE and RA, we found a reduced risk of overall CV events associated with current HCQ use including reductions in VTE and trends towards reductions in MI and stroke. These findings suggest a possible cardiovascular preventative benefit of HCQ use. This article is protected by copyright. All rights reserved.
Authors: Daniel J Wallace; Vineet S Gudsoorkar; Michael H Weisman; Swamy R Venuturupalli Journal: Nat Rev Rheumatol Date: 2012-07-17 Impact factor: 20.543
Authors: Daniel H Solomon; Elena Massarotti; Rajesh Garg; Jun Liu; Claire Canning; Sebastian Schneeweiss Journal: JAMA Date: 2011-06-22 Impact factor: 56.272
Authors: J Antonio Aviña-Zubieta; Fergus To; Kateryna Vostretsova; Mary De Vera; Eric C Sayre; John M Esdaile Journal: Arthritis Care Res (Hoboken) Date: 2017-05-09 Impact factor: 4.794
Authors: Cynthia S Crowson; Katherine P Liao; John M Davis; Daniel H Solomon; Eric L Matteson; Keith L Knutson; Mark A Hlatky; Sherine E Gabriel Journal: Am Heart J Date: 2013-08-29 Impact factor: 4.749
Authors: Jennifer C E Lane; James Weaver; Kristin Kostka; Talita Duarte-Salles; Maria Tereza F Abrahao; Heba Alghoul; Osaid Alser; Thamir M Alshammari; Patricia Biedermann; Juan M Banda; Edward Burn; Paula Casajust; Mitchell M Conover; Aedin C Culhane; Alexander Davydov; Scott L DuVall; Dmitry Dymshyts; Sergio Fernandez-Bertolin; Kristina Fišter; Jill Hardin; Laura Hester; George Hripcsak; Benjamin Skov Kaas-Hansen; Seamus Kent; Sajan Khosla; Spyros Kolovos; Christophe G Lambert; Johan van der Lei; Kristine E Lynch; Rupa Makadia; Andrea V Margulis; Michael E Matheny; Paras Mehta; Daniel R Morales; Henry Morgan-Stewart; Mees Mosseveld; Danielle Newby; Fredrik Nyberg; Anna Ostropolets; Rae Woong Park; Albert Prats-Uribe; Gowtham A Rao; Christian Reich; Jenna Reps; Peter Rijnbeek; Selva Muthu Kumaran Sathappan; Martijn Schuemie; Sarah Seager; Anthony G Sena; Azza Shoaibi; Matthew Spotnitz; Marc A Suchard; Carmen O Torre; David Vizcaya; Haini Wen; Marcel de Wilde; Junqing Xie; Seng Chan You; Lin Zhang; Oleg Zhuk; Patrick Ryan; Daniel Prieto-Alhambra Journal: Lancet Rheumatol Date: 2020-08-21