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Antimalarial drugs and malignancy: no evidence of a protective effect in rheumatoid arthritis
  1. S Bernatsky1,
  2. A Clarke1,2,
  3. S Suissa1,3
  1. 1
    Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, V-Building, Montreal, Québec H3A 1A1, Canada
  2. 2
    Division of Allergy & Clinical Immunology, McGill University Health Centre, Montreal, Canada
  3. 3
    Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
  1. Dr Sasha Bernatsky, MD, PhD, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, V-Building, Montreal, Québec H3A 1A1, Canada; sasha.bernatsky{at}mail.mcgill.ca

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Antimalarial agents, particularly hydroxychloroquine, are frequently used drugs in rheumatology, particularly in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). A growing awareness of increased malignancies in these autoimmune rheumatic conditions has raised suspicions that drugs may alter cancer risk in such patients. In vitro, antimalarial agents have been invoked as potentially increasing1 or decreasing2 neoplastic processes in breast cancer cells. It has also been suggested that these drugs may decrease the in vitro activity of lymphocytic leukaemia cells.3 However, there exists no definitive literature to show any explicit effect of antimalarial agents on cancer risk in clinical populations.

We have examined malignancy risk after antimalarial drug exposures, using a case–control design nested within a population-based …

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