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Research Article

Skin and ophthalmic complications of chloroquine and hydroxychloroquine in patients with rheumatoid arthritis and systemic lupus erythematous

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ABSTRACT

Immunosuppressive agents are routinely used to control autoimmunity. However, some adverse events are correlated to their clinical applications. The aim of this study was to study the clinical findings and ocular and cutaneous side effects of chloroquine (CQ) and hydroxychloroquine (HCQ), as current immunomodulators, in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). This descriptive study was performed on 360 individuals referred to the Rheumatology clinic during 2003–2020. Demographic characteristics and other information were collected from patients with RA and SLE. Skin and ocular complications were evaluated in patients who were on treatment with CQ and HCQ. Study populations consisted of 199 subjects with RA and 161 cases with SLE. The frequencies of skin and ocular complications in all patients treated with CQ and HCQ were 32 (17.65%) and 94 (51.9%), respectively. The prevalence of skin complications in patients with RA and SLE was 20 (10.05%) and 22 (13.66%), respectively. The frequencies of ocular complications in patients with RA and SLE were, respectively, 58 (29.4%) and 36 (22.5%). Multiple logistic regression analysis revealed that ophthalmic complications of CQ and HCQ in all patients were dependent on the effects of the duration of drug uses, disease duration, and cumulative doses (p < 0.05), unlike skin complications. Disease types had no effect on ocular complications. Based on these findings, treatment with CQ and HCQ participates in some skin and ocular complications in patients with RA and SLE which are largely associated with the duration of disease and treatment.

Abbreviations

Chloroquine: CQ; Hydroxychloroquine: HCQ; Rheumatoid arthritis: RA; Systemic lupus erythematous: SLE; glomerular basement membrane: GBM.

Acknowledgments

The authors would like to thank all individuals who helped to the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

B.Z participated in the conceptualization, data curation, and supervision. A.M.H participated in writing the original draft. S.M.R contributed to the conceptualization and data curation. H.A participated in the conceptualization and statistical analysis of data. H.M reviewed and edited the final manuscript. All authors read and approved the final manuscript.

Availability of data and material

All data generated or analyzed during this study are included in this manuscript.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Kashan University of Medical Sciences (IR.KAUMS.MEDNT.REC.1399.091). Informed consent was taken before taking part in the study. All methods were approved by the Ethics Committee of Kashan University of Medical Sciences and carried out in accordance with the Helsinki declaration.

Additional information

Funding

This study was financially supported by Kashan University of Medical Sciences [Grant No: 99117].

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