More than lupus erythematosus!

Hydroxychloroquine is a very "old" and classic anti-rheumatic drug, which was born in 1944 and officially launched in 195 It is a hydroxy derivative of chloroquine and belongs to the 4-aminoquinoline class of antimalarial dru.

Systemic lupus erythematosus

Hydroxychloroquine is widely recognized for the treatment of systemic lupus erythematosus (SL.

The mechanisms of action of hydroxychloroquine include: immunosuppressive effects by blocking antigen presentation, inhibiting pro-inflammatory cytokine and prostaglandin synthesis, inhibiting TLR signaling, and blocking the response of DNA to DNA antibodi.

Hydroxychloroquine is more effective in the treatment of mild SLE, especially in patients on long-term medicati.

• In 2007, The Lancet recommended hydroxychloroquine as the basic drug for the treatment of S.

  
  

• The European League of Rheumatology (EULAR) expert consensus published in 2008 recommended hydroxychloroquine as the main treatment for S.

  
  

• 2020 "China Systemic Lupus Erythematosus Guidelines": Long-term use of hydroxychloroquine as a basic treatment drug is recommended for patients without contraindicatio.

  
  

• 2021 "Asia-Pacific Systemic Lupus Erythematosus Management Consensus": It is recommended that all SLE patients routinely use hydroxychloroquine (except those with contraindications), with a dose of ≤5mg/kg.

  
  

Rheumatoid arthritis

Hydroxychloroquine plays an important role in the long-term treatment of rheumatoid arthritis (R.

China's "2018 Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis" deleted the recommendation on HCQ monothera.

Dual combination regimen: chloroquine (HCQ) + methotrexate (MTX) or sulfasalazine (SSZ)

In clinical work, the HCQ+MTX combination scheme is the most comm.

Triple regimen: hydroxychloroquine (HCQ) + methotrexate (MTX) + sulfasalazine (SSZ)

Triple therapy can be said to be the " ceiling " of the traditional synthetic disease-modifying anti-rheumatic drug (csDMARDs) progra.

Sjogren's syndrome

Hydroxychloroquine can improve the symptoms of dry eyes and dry mouth to a certain extent, reduce the inflammatory index erythrocyte sedimentation rate (ESR), immunoglobulin (IgG), improve skin erythema symptoms, reduce fatigue and improve joint pain sympto.

In China, hydroxychloroquine monotherapy is mainly used for patients with Sjögren's syndrome without vital organ involveme.

Antiphospholipid Syndrome (APS)

Hydroxychloroquine has anti-inflammatory and antithrombotic properties and has anticoagulant effects to prevent antiphospholipid antibody (APL)-induced placental damage

Results of an open-label French study of HCQ in the treatment of lupus erythematosus showed that HCQ has important value in the treatment of thrombotic APS and can

The "Expert Consensus on Diagnosis and Management of Antiphospholipid Syndrome" recommends: For APS patients who have failed conventional treatment, APS with SLE or other systemic autoimmune diseases, high-risk aPLs spectrum and OAPS patients with a history of thrombosis, it is recommended that pre-pregnancy be based on the Antibody titer and other conditions, apply hydroxychloroquine 200~400mg.

common side effects

Hydroxychloroquine is one of the safer anti-rheumatic drugs with few serious adverse reactio.

Common adverse reactions include gastrointestinal tract, such as nausea, vomiting, diarrhea, anorexia, e.

, the dose can be reduced by half or the drug can be discontinued for observation, and the original dose can be resumed after the symptoms are reliev.

Another important adverse reaction is retinopathy, which is also the main factor limiting the long-term use of the dr.

The incidence of retinopathy was positively related to cumulative dose and duration of treatme.

The "2020 Guidelines for Systemic Lupus Erythematosus in China" recommends annual eye examinations at baseline and 5 years after taking hydroxychloroquine for those without high-risk facto.

Have an eye exam to detect adverse effects from the dr.

Hydroxychloroquine is a very "old" and classic anti-rheumatic drug, which was born in 1944 and officially launched in 195 It is a hydroxy derivative of chloroquine and belongs to the 4-aminoquinoline class of antimalarial dru.

It has major pharmacological effects such as anti-inflammatory and immune regulati.

It has applications in cardiovascular disease, kidney disease, tumor, rheumatism and other fiel.

The application of hydroxychloroquine in the field of rheumatolo.

Systemic lupus erythematosus

Hydroxychloroquine is widely recognized for the treatment of systemic lupus erythematosus (SL.

In general, unless there are contraindications, patients with any degree of disease activity and type of SLE should be treated with hydroxychloroquine or chloroquine ( Hydroxychloroquine accounts for 95% of all antimalarial prescriptions for rheumatic diseases)

The status of hydroxychloroquine in the treatment of systemic lupus erythematosus is evide.

The mechanisms of action of hydroxychloroquine include: immunosuppressive effects by blocking antigen presentation, inhibiting pro-inflammatory cytokine and prostaglandin synthesis, inhibiting TLR signaling, and blocking the response of DNA to DNA antibodi.

Hydroxychloroquine is more effective in the treatment of mild SLE, especially in patients on long-term medicati.

In addition to improving clinical symptoms such as SLE rash and joint pain, hydroxychloroquine can also improve hair loss, reduce the risk of infection and thrombosis, improve cardiac conditions, help relieve lupus nephritis, reduce multiple organ damage, and improve long-term S.

survival ra.

Continued hydroxychloroquine therapy also plays an important role in preventing lupus recurrence during pregnan.

 

• In 2007, The Lancet recommended hydroxychloroquine as the basic drug for the treatment of S.
  
  

• The European League of Rheumatology (EULAR) expert consensus published in 2008 recommended hydroxychloroquine as the main treatment for S.
  
  

• 2020 "China Systemic Lupus Erythematosus Guidelines": Long-term use of hydroxychloroquine as a basic treatment drug is recommended for patients without contraindicatio.
  
  

• 2021 "Asia-Pacific Systemic Lupus Erythematosus Management Consensus": It is recommended that all SLE patients routinely use hydroxychloroquine (except those with contraindications), with a dose of ≤5mg/kg.
  
  

In 2007, The Lancet recommended hydroxychloroquine as the basic drug for the treatment of S.

The European League of Rheumatology (EULAR) expert consensus published in 2008 recommended hydroxychloroquine as the main treatment for S.

2020 "China Systemic Lupus Erythematosus Guidelines": Long-term use of hydroxychloroquine as a basic treatment drug is recommended for patients without contraindicatio.

2021 "Asia-Pacific Systemic Lupus Erythematosus Management Consensus": It is recommended that all SLE patients routinely use hydroxychloroquine (except those with contraindications), with a dose of ≤5mg/kg.

Rheumatoid arthritis

Hydroxychloroquine plays an important role in the long-term treatment of rheumatoid arthritis (R.

Immunomodulators can be used in patients with mild disease activity, or adjuvant therapy in patients with moderate to severe disease activi.

The results of the cohort analysis showed that the incidenceof RA was significantly reduced with hydroxychloroquine, and the progression of erosive arthritis could be delay.

China's "2018 Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis" deleted the recommendation on HCQ monothera.

But at present, HCQ is still the preferred traditional synthetic disease anti-rheumatic drugs ( csDMARDs) in the treatment of RA in Chi.

Dual combination regimen: chloroquine (HCQ) + methotrexate (MTX) or sulfasalazine (SSZ)

In clinical work, the HCQ+MTX combination scheme is the most comm.

The combination of these two drugs can have an effect of 1+1>2, and the side effects are 1+1<< Pharmacokinetic studies have shown that HCQ+MTX treatment can increase the blood concentration of MTX, play a synergistic effect, and can also reduce the acute liver damage of the drug by reducing the peak concentration (Cmax) of M.

Triple regimen: hydroxychloroquine (HCQ) + methotrexate (MTX) + sulfasalazine (SSZ)

Triple therapy can be said to be the " ceiling " of the traditional synthetic disease-modifying anti-rheumatic drug (csDMARDs) progra.

The combination of the three drugs can better control the activity of the disease, which can meet the treatment needs of most RA patient.

If the efficacy is still poor, it may be necessary to consider switching to or adding biologic disease-modifying anti-rheumatic drugs (bDMARDs) or combined targeted synthetic disease-modifying anti-rheumatic drugs (tsDMARDs.

Sjogren's syndrome

Hydroxychloroquine can improve the symptoms of dry eyes and dry mouth to a certain extent, reduce the inflammatory index erythrocyte sedimentation rate (ESR), immunoglobulin (IgG), improve skin erythema symptoms, reduce fatigue and improve joint pain sympto.

In China, hydroxychloroquine monotherapy is mainly used for patients with Sjögren's syndrome without vital organ involveme.

About 1 year of treatment can improve the symptoms of dryness and fatigue, reduce ESR and immunoglobulin levels, and improve the ESSDAI score and the physician's overall disease sco.

Antiphospholipid Syndrome (APS)

Hydroxychloroquine has anti-inflammatory and antithrombotic properties and has anticoagulant effects to prevent antiphospholipid antibody (APL)-induced placental damage

Results of an open-label French study of HCQ in the treatment of lupus erythematosus showed that HCQ has important value in the treatment of thrombotic APS and can
effectively reduce the risk of thrombosi.

In a retrospective study in Europe, adding HCQ to routine care in pregnant women with lupus erythematosus significantly improved refractory obstetric A.

The overall safety of HCQ for both mother and fetus was demonstrated during pregnancy as well as postnatal follow-up da.

The "Expert Consensus on Diagnosis and Management of Antiphospholipid Syndrome" recommends: For APS patients who have failed conventional treatment, APS with SLE or other systemic autoimmune diseases, high-risk aPLs spectrum and OAPS patients with a history of thrombosis, it is recommended that pre-pregnancy be based on the Antibody titer and other conditions, apply hydroxychloroquine 200~400mg.

common side effects

Hydroxychloroquine is one of the safer anti-rheumatic drugs with few serious adverse reactio.

Common adverse reactions include gastrointestinal tract, such as nausea, vomiting, diarrhea, anorexia, e.

, the dose can be reduced by half or the drug can be discontinued for observation, and the original dose can be resumed after the symptoms are reliev.

Another important adverse reaction is retinopathy, which is also the main factor limiting the long-term use of the dr.

The incidence of retinopathy was positively related to cumulative dose and duration of treatme.

The "2020 Guidelines for Systemic Lupus Erythematosus in China" recommends annual eye examinations at baseline and 5 years after taking hydroxychloroquine for those without high-risk facto.

Have an eye exam to detect adverse effects from the dr.