Table 1

Antimalarials and lupus activity

ReferenceStudy typenAMRaceAge (mean)Follow-upMain outcomesAM effect
Canadian Group, 19918RCT25 HCQHCQNA4524 weeksSLE flare (ACR manifestations)Lower rate of SLE flare: (36% vs 73%, p = 0.02)
22 PLSevere flareLower rate of severe flare: (4% vs 23%, p = 0.06)
Prednisone doseNo difference in dose of prednisone
Meinao et al, 19969RCT11 CQCQW (61%)3212 monthsSLE flare (SLEDAI)Lower rate of SLE flare: (18% vs 83%, p<0.01)
12 PlPrednisone doseHigher rate of prednisone reduction: (82% vs 25%. p<0.01)
Williams et al, 199410RCT40 HCQHCQW (44%)4248 weeksPainful/swollen jointsLower self-assessed severity of joint pain (p = 0.02)
31 PLB (42%)Grip strength
Self-assessed score of severity of joint pain
Tsakonas et al, 199818Retrospective data of extended RCT25 HCQHCQNA4542 monthsTime to develop a major flareLower rate of major flare: (28% vs 50%, p = 0.08)
22 PL
Wozniacka et al, 200612Prospective cohort25CQNA40.63 monthsChange in SLAM scoreHigher reduction in SLAM score: (9.47 vs 4.92, p<0.001)
Costedoat et al, 200613Prospective cohort120HCQNA366 monthsSLE flare (SLEDAI)Lower HCQ blood levels in patients with flare: (703 vs 1128, p = 0.006)
Serum levels of HCQ
Kasitanon et al, 200617Retrospective cohort11 HCQHCQB (55%)29.912 monthsRemission in membranous lupus nephritis treated with MMFHigher rate of membranous lupus nephritis remission: (64% vs 22%, p = 0.036)
18 no HCQ
Barber et al, 200616Retrospective cohort35HCQW (85.7%)32.238 monthsSustained remission of lupus nephritis (⩾3 years)More patients on sustained remission on HCQ: (94% vs 53%, p = 0.01)
Levy et al, 200111RCT10 HCQHCQW (45%)29Pregnancy durationSLE activity (SLEPDAI) during pregnancyImprovement in SLEPDAI score only in patients on HCQ (p = 0.038)
10 PLPrednisone doseLower prednisone dose at delivery: (4.5 vs 13.7 mg/day, p<0.05)
Clowse et al, 200614Prospective cohort56 HCQHCQW (61%)NAPregnancy durationSLE activity (PEA, SLEDAI) during pregnancyWomen stopping HCQ higher lupus activity than those never treated and those taking HCQ:
38 HCQ previous to pregnancyPrednisone use during pregnancyFlare rate: 55% vs 36%, vs 30%, p = 0.053
163 no HCQMaximum SLEDAI: 6.5 vs 5.2 vs 4.2, p = 0.062
SLEDAI >4: 84% vs 52%, vs 62%, p = 0.008
Maximum prednisone dose: 21 vs 23 vs 16, p = 0.056
Cortes-Hernandez et al, 200215Prospective cohort60CQNA28Pregnancy durationSLE flares (SLEDAI) during pregnancyCQ discontinuation increased flares (p = 0.02)
  • ACR, American College of Rheumatology; AM, antimalarial; B, black; CQ, chloroquine; HCQ, hydroxychloroquine; MMF, mycophenolate mofetil; NA, not available; PEA, Physician's Estimate of Activity; PL, placebo; RCT, randomised controlled trial; SLAM, Systemic Lupus Activity Measure; SLE, systemic lupus erythematosus; SLE(P)DAI, SLE (Pregnancy) Disease Activity Index; W, white.