Evaluation of the role of hydroxychloroquine as a lipid profile improving and glucose adjusting drug in Egyptian females with inactive rheumatoid arthritis

Abstract

Background/aim Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that leads to joint destruction and disability with increased risk of cardiovascular disease (CVD), a leading cause of morbidity and mortality in RA. Modifying CVD risk factors, such as lowering plasma glucose and total cholesterol, may be helpful for preventing CVD. A disease-modifying antirheumatic drugs (DMARD) hydroxychloroquine (HCQ) with a good safety profile and low cost has been reported to improve lipid profiles and glucose level in RA. The study was designed to evaluate the responsibility of HCQ in the improvement of lipid profile and glucose level in Egyptian Inactive Rheumatoid Arthritis (RA) females. Subjects and methods This trial study included fifty adult RA females in remission treated with 400 mg daily of HCQ orally for 6 months. The patients are regular visiting outpatient clinic of rheumatology unit at the department of Rheumatology and Rehabilitation, Mataria Teaching Hospital, National Institute of Neuro-Motor System (NINMS) and Rheumatology clinic at Centre of Medical Excellence of National Research Centre, Cairo, Egypt. Visits and follow-up are monthly to ensure adherence to treatment. All the patients have been evaluated at the start of the trial, after 3 and 6 months. Lipid profile, fasting blood sugar (FBS), anthropometric parameters and systolic and diastolic blood pressure were assessed. Results After 3 months of treatment, most of the metabolic characteristics were improved significantly. FBS level was significantly lowered (P<0.001), and lipid profiles were significantly improved as total cholesterol (P<0.001), HDL-cholesterol (P<0.001), LDL-cholesterol (P<0.001) and artherogenic index (TC/HDL-cholesterol (P<0.001) and LDL-C/HDL-cholesterol(P<0.001). The triglyceride level and the anthropometric variables were significant statistically as (P<0.001). Moreover after 6 months, all metabolic parameters were statistically improved as FBS (P<0.001), TC (P<0.001), TG (P<0.001), HDL-Cholesterol, LDL-cholesterol and artherogenic index (P<0.0001). Moreover, the best improvement was at 6 months of treatment. Conclusion HCQ significantly improved the blood glucose level in patients with inactive RA, in addition to the serum levels of TC, TG, HDL-Cholesterol, LDL-Cholesterol and arthrogenic index. Moreover, lessen the use of anti-lipids and diabetic medications.