Antimalarial drug toxicities in patients with cutaneous lupus and dermatomyositis: A retrospective cohort study - 13/12/17
Abstract |
Background |
Although existing evidence demonstrates the efficacy of antimalarials for rheumatic skin disease, the safety of these medications, and particularly quinacrine, remains debated.
Objective |
We investigated the toxicity risk associated with antimalarials in patients with cutaneous lupus erythematosus and dermatomyositis.
Methods |
A total of 532 patients (mean age, 52.29 years; sample composition by sex, 85.15% female vs 14.85% male) were selected from 2 databases on cutaneous lupus erythematosus (69.92%) and dermatomyositis (30.08%). Details regarding treatment and toxicities were extracted and 5 treatment courses were defined (ie, hydroxychloroquine [HCQ], chloroquine [CQ], quinacrine [Q], HCQ-Q combination therapy [HCQ-Q], and CQ-Q combination therapy [CQ-Q]). The hazard ratio for each major toxicity was estimated by using the Cox proportional hazard model to compare the different treatments with HCQ.
Results |
The most common toxicities included cutaneous eruption, gastrointestinal upset, mucocutaneous dyspigmentation, neurologic toxicity, and retinopathy. The hazards of cutaneous eruption, gastrointestinal upset, and neurologic toxicities were lower with HCQ-Q than with HCQ; however, this may represent selection bias. Although there was increased retinopathy risk with CQ and CQ-Q versus with HCQ, retinopathy was not seen with Q.
Limitations |
Retrospective analysis.
Conclusions |
With the exception of retinopathy, which was not seen with Q, the risks for other toxicities associated with Q monotherapy or combination treatment were not significantly different from those with HCQ.
Le texte complet de cet article est disponible en PDF.Key words : chloroquine, cutaneous lupus erythematosus, dermatomyositis, drug reactions, hydroxychloroquine, quinacrine
Abbreviations used : CLE, CQ, CQ-Q, DM, HCQ, HCQ-Q, HR, Q, SLE, TLR-4, TLR-8
Plan
| Supported by the Veterans Health Administration Office of Research and Development and Biomedical Laboratory Research and Development of the US Department of Veterans Affairs Merit Review (grant 5 I01 BX000706-04 to principal investigator Dr Werth) and by the US Department of Health and Human Services and National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (grant R21 AR066286 to principal investigator Dr Werth). |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 78 - N° 1
P. 100 - janvier 2018 Retour au numéro
Article précédent
- Adalimumab for nail psoriasis: Efficacy and safety from the first 26 weeks of a phase 3, randomized, placebo-controlled trial
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- Changing antimalarial agents after inefficacy or intolerance in patients with cutaneous lupus erythematosus: A multicenter observational study
- François Chasset, Laurent Arnaud, Marie Jachiet, Jean-Benoît Monfort, Jean-David Bouaziz, Florence Cordoliani, Martine Bagot, Annick Barbaud, Camille Francès
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