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Modern Rheumatology Volume 31, 2021 - Issue 6
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Connective tissue diseases and related disorders

Effect of hydroxychloroquine on angiographic progression in routine treatment of Takayasu arteritis

Chen Rongyia Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
,
Ji Zongfeia Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
,
Lin Jiangc Department of Radiology, Zhongshan Hospital Fudan University, Shanghai, ChinaView further author information
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Wu Sifana Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Ma Lingyinga Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Sun Yinga Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Yu Wenshua Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Cui Xiaomenga Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Kong Xiufanga Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
,
Dai Xiaomina Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
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Ma Lilia Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaView further author information
,
Li Yanshand Department of Rheumatology and Immunology, Linyi People’s Hospital, Shandong, ChinaCorrespondence[email protected]
View further author information
&
Jiang Lindia Department of Rheumatology, Zhongshan Hospital Fudan University, Shanghai, China;b Evidence-based Medicine Center, Fudan University, Shanghai, ChinaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-7747-7788View further author information
ORCID Icon show all
Pages 1135-1141 | Received 06 Oct 2020, Accepted 25 Dec 2020, Published online: 15 Apr 2021
 
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Abstract

Objectives

Hydroxychloroquine (HCQ), an anti-malarial drug, is widely used in the treatment of rheumatic diseases. However, the benefits of HCQ in the treatment of Takayasu arteritis (TA) remain unclear, especially in terms of alleviation of vascular progression.

Methods

This longitudinal observational retrospective study was based on the East China TA cohort. Patients received routine treatment with prednisone and immunosuppressants. Fifty TA patients who underwent magnetic resonance angiography two times within a 1.5-year follow-up period of monitoring vascular changes were divided into HCQ and non-HCQ groups according to whether HCQ was prescribed. Changes in angiographic features were compared. Multivariate Cox regression analysis was employed to further validate the results.

Results

Of 50 TA patients, 21 were prescribed HCQ. The two groups shared a similar disease course, vascular types, prednisone with immunosuppressants intervention strategy, globin level, and disease remission rate at 6 months. The HCQ group showed greater reduction in the inflammatory indices erythrocyte sedimentation rate and C-reactive protein (CRP) level (p < .05), and a significantly lower incidence of angiographic progression than the non-HCQ group (19.0% vs. 51.7%, p = .035). After adjustment for age and usage of tocilizumab, angiographic progression was found to be independently associated with CRP (hazard ratio [95% confidence interval], HR [95% CI]: 1.102 [1.000–1.024], p = .046), and the usage of HCQ (HR [95% CI]: 0.266 [0.075–0.940], p = .040).

Conclusion

HCQ enhanced the anti-inflammatory effect of routine treatment strategies with prednisone and immunosuppressants, and alleviated angiographic progression in TA.

Conflict of interest

None.

Additional information

Funding

The study was supported by the National Natural Science Foundation of China [NSFC Grant No. 81801598 and 81771730].

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