A study led by Johns Hopkins Medicine found that patients with discoid lupus erythematosus (skin lupus) prescribed hydroxychloroquine were less likely to develop certain complications, such as diabetes, hypertension, and coronary artery disease.
The research, published on April 17 in the Journal of the American Academy of Dermatology, is among the first to explore whether hydroxychloroquine, a treatment for systemic lupus erythematosus (SLE), benefits patients with chronic cutaneous lupus alone.
Key Details
- Two cohorts were analyzed: one from Johns Hopkins (106 patients, 60 on hydroxychloroquine) and one from the TriNetX database (2,260 matched pairs, total 4,520 patients, half on hydroxychloroquine).
- All patients had discoid lupus and no other autoimmune conditions; those on oral corticosteroids, immunosuppressants, or biologics were excluded.
Johns Hopkins cohort: Hydroxychloroquine users showed lower rates of hyperlipidemia (23.3% vs 47.8%), peripheral artery disease (1.7% vs 17.4%), angina (3.3% vs 26.1%), and coronary artery disease (10.0% vs 26.1%) over five years.
TriNetX cohort: Hydroxychloroquine use was associated with lower risk of hypertension (14.1% vs 17.3%), hyperlipidemia (8.4% vs 15.1%), type 2 diabetes (4.3% vs 6.3%), stroke (1.0% vs 2.3%), and coronary artery disease (4.2% vs 5.9%).
No significant difference in hypertension, type 2 diabetes, heart attack, or stroke was observed in the Johns Hopkins cohort.
Background
Discoid lupus has historically been viewed as skin-limited, but newer research links it to systemic inflammation and elevated heart disease risk similar to SLE.
Lead author Dr. Jun Kang stated that treatments often focus on skin symptoms rather than systemic complications.
The study was supported by a Dermatology Foundation Medical Dermatology Career Development Award.
Statement
Dr. Jun Kang: "Our study found that hydroxychloroquine use was associated with better cardiovascular and cardiometabolic health outcomes, including diabetes, in patients after five years."
The team plans to identify which patients benefit most from hydroxychloroquine and aims to establish new treatment guidelines.