Patients with systemic lupus erythematosus who use hydroxychloroquine may have a lower risk of experiencing cardiovascular events, including myocardial infarction and stroke, compared with those who don't use the medication, according to a recent study.

In the cohort study, published in JAMA Network Open, investigators evaluated the association between hydroxychloroquine use and cardiovascular (CV) events, including myocardial infarction (MI), stroke, and other thromboembolic events (OTEs) in 52,883 patients with lupus. The analysis, using data from the National French Healthcare Database from 2010 to 2020, identified 2,107 patients with composite CV outcomes and matched them with 16,892 controls.

The average age of the participants was 44.23 years (standard deviation [SD] = 16.09 years). Among all of the patients, 86.6% (n = 45,255) were female. The patients were followed for an average duration of 9.01 years (SD = 2.51 years).

Among the individual cardiovascular events, there were 669 instances of MI, 916 instances of stroke, and 696 instances of OTEs. The investigators found that current hydroxychloroquine use within 90 days was associated with a significantly reduced risk of composite CV events (odds ratio [OR] = 0.63), MI (OR = 0.72), stroke (OR = 0.69), and OTEs (OR = 0.58) compared with no hydroxychloroquine exposure within the past 1 year. Remote use of hydroxychloroquine (91 to 365 days prior) did not show a significant reduction in CV event risk.

Compared with those with no recent exposure, the OR for experiencing composite CV events in patients currently using hydroxychloroquine was 0.63 (95% confidence interval [CI] = 0.57–0.69). The ORs for individual events were 0.72 for MI (95% CI = 0.60–0.85), 0.69 for stroke (95% CI = 0.60–0.81), and 0.58 for OTEs (95% CI = 0.49–0.69).

The findings suggested that continued hydroxychloroquine use may be associated with a lower risk of CV events, while discontinuation of the drug may attenuate this benefit. The study controlled for age, sex, prior use of CV medications, and other potential confounders. However, the absence of clinical and biological data, along with potential residual confounding, was acknowledged as a limitation.

Full disclosures can be found in the published study.