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Factors Associated with Survival and Discontinuation of Anti-Malarial Agents in Systemic Lupus Erythematosus: Results from a Tertiary Swedish Referral Centre
Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-4875-5395
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2024 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, no 5, article id 1485Article in journal (Refereed) Published
Abstract [en]

Background: Antimalarial agents (AMAs) are cornerstone drugs in the treatment of systemic lupus erythematosus (SLE), and their use has established benefits, such as improved prognosis and decelerated accrual of organ damage. The aim of this study was to investigate the frequency of discontinuation of AMAs and associated factors in a Swedish SLE population.

Methods: We retrieved data from a regional SLE register where all patients fulfilled the 1982 ACR and/or the 2012 SLICC classification criteria. A total of 328 subjects were included in the analysis.

Results: Altogether, 92.4% (303/328) had been prescribed AMAs at some point during their disease. At the last available visit, 67.7% (222/328) were currently prescribed AMAs. Among individuals who had discontinued use, 24.7% (20/81) had developed a contraindication. Side effects were also common reasons for discontinuation (n = 38); gastrointestinal symptoms (52.6%, 20/38) were most common. Patients who discontinued had accrued more organ damage at the last visit (mean SDI: 2.9; SD: 2.8) compared with those still on AMAs (mean SDI: 1.4; SD: 1.8; p = 0.001).

Conclusions: Most patients had been exposed to AMAs, but 25% discontinued therapy. Among side effects leading to discontinuation, >50% were gastrointestinal, calling for adequate gastroprotection towards drug retention and prevention of organ damage progression.

Place, publisher, year, edition, pages
MDPI, 2024. Vol. 13, no 5, article id 1485
Keywords [en]
systemic lupus erythematosus, antimalarials, hydroxychloroquine, chloroquine, drug survival
National Category
Rheumatology and Autoimmunity
Identifiers
URN: urn:nbn:se:oru:diva-112577DOI: 10.3390/jcm13051485ISI: 001183350000001PubMedID: 38592294Scopus ID: 2-s2.0-85187873941OAI: oai:DiVA.org:oru-112577DiVA, id: diva2:1846992
Funder
Swedish Research Council, 2023-02256Swedish Rheumatism Association, R-939149; R-969696Region Östergötland, RÖ-960604King Gustaf V Jubilee Fund, FAI-2020-0663; FAI-2020-0741Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseSwedish Society of Medicine, SLS-974449Nyckelfonden, OLL-974804Region Stockholm, FoUI-955483Karolinska Institute
Note

This work has been supported by grants from the Swedish Research Council [2023-02256], the Swedish Rheumatism Association [R-939149 and R-969696], the Region Östergötland [RÖ-960604], the Gustafsson Foundation [2023-36 and 2021-26], the King Gustaf V’s 80-year Anniversary Foundation [FAI-2020-0663 and FAI-2020-0741), the King Gustaf V and Queen Victoria’s Freemasons Foundation [2021], Swedish Society of Medicine [SLS-974449], Nyckelfonden [OLL-974804], Professor Nanna Svartz Foundation [2021-00436], Region Stockholm [FoUI-955483] and Karolinska Institutet.

Available from: 2024-03-26 Created: 2024-03-26 Last updated: 2024-04-10Bibliographically approved

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