The treatment of systemic lupus erythematosus is largely empiric and is based on the presence of specific symptoms. Patients with lesions of the skin and mucous membranes, as well as malaise, easy fatigability, arthritis and pleuritic pain, are of ten treated with antimalarial drugs. The Canadian Hydroxychloroquine Study Group conducted a double-blind, multicenter clinical trial to evaluate the effectiveness of hydroxychloroquine in controlling flareups of systemic lupus erythematosus.
The study included 47 patients with clinically stable disease who had been receiving hydroxychloroquine for at least six months. Twenty-two patients continued to receive hydroxychloroquine, and 25 were switched to placebo. Follow-up continued for six months.
Patients receiving placebo were 2.5 times more likely to have an exacerbation of symptoms than patients who continued to receive hydroxychloroquine. The relative risk of severe exacerbation necessitating withdrawal from the study was 6.1 times higher in patients receiving placebo.
The study results confirm that hydroxychloroquine can maintain clinical quiescence of systemic lupus erythematosus. In an accompanying editorial, Stolley suggests that hydroxychloroquine should take a more visible place among the treatments available to patients with systemic lupus erythematosus. (New England Journal of Medicine, January 17, 1991, vol. 324, pp. 150, 189.)
COPYRIGHT 1991 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group
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