Supplemental Hydroxychloroquine Therapy Regulates Adipokines in Patients With Systemic Lupus Erythematosus With Stable Disease

Abstract

\n Background: In patients with systemic lupus erythematosus (SLE), a higher frequency of atherosclerotic lesions is associated with poor prognosis. Hydroxychloroquine (HCQ) has been reported to improve the lifespan and the prognosis of dyslipidaemia in patients with SLE, but the mechanism is unclear. We investigated the effect of supplemental HCQ treatment on the levels of serum cytokines associated with atherosclerosis in patients with stable SLE.Methods: Patients with SLE who received supplemental HCQ and maintained low disease activity between January 2016 and September 2020 were included in this study. Disease activity was assessed by SLE disease activity index, Cutaneous Lupus Erythematous Disease Area and Severity Index and Lupus Low Disease Activity State, and serum complement titres, anti-dsDNA antibodies, serum insulin and serum cytokines (adiponectin, resistin, and leptin) were analyzed before and after HCQ treatment.Results: Forty-one patients (4 males and 37 females, mean age 41.3 ± 13.2 years) were included. Serum adiponectin levels were significantly increased after 3 months of HCQ treatment compared to baseline, and serum resistin levels were significantly reduced. The change in serum resistin level after HCQ administration was correlated with a significant reduction in serum TNF-α, interleukin (IL)-6, IL-8, and IL-1RA levels.Conclusions: Supplemental HCQ treatment in patients with dsDNA antibodies improved lipid levels. HCQ may improve prognosis by controlling disease activity in SLE and reducing risk factors for atherosclerosis.