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We thank Lai et al for their correspondence1 in which they share their study findings that endorse our own study findings2 reporting an absence of a link between hydroxychloroquine and Alzheimer's disease. More robust research on the topic emerging from randomised trials would of course be welcomed. However, it should be kept in mind that the effect of hydroxychloroquine on progression of dementia in early Alzheimer's disease has been investigated in 2001 in a randomised, placebo-controlled trial, and the results of the study showed no effect of treatment against placebo.3 Taken all together, these results from two large national databases and a randomised controlled trial are reassuring. Therefore, we do agree with Lai et al that withdrawal of hydroxychloroquine in people on long-term therapy, especially in older people and those receiving the drug for an autoimmune disease, is not justified.
Handling editor Josef S Smolen
Contributors All authors contributed to this response letter.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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