Risk of uveitis in autoimmune diseases patients treated with hydroxychloroquine: A population‐based retrospective cohort study

Author:

Bai Yi‐Chiao12ORCID,Perng Wuu‐Tsun3,Huang Jing‐Yang4,Liao Pei‐Lun4,Wei James Cheng‐Chung156

Affiliation:

1. Institute of Medicine Chung Shan Medical University Taichung Taiwan

2. Department of Optometry Shu‐Zen Junior College of Medicine and Management Kaohsiung Taiwan

3. Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Graduate Institute of Medicine Chung Shan Medical University Taichung Taiwan

4. Department of Medical Research Chung Shan Medical University Hospital Taichung Taiwan

5. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine Chung Shan Medical University Hospital Taichung Taiwan

6. Graduate Institute of Integrated Medicine China Medical University Taichung Taiwan

Abstract

AbstractObjectiveUveitis is a common manifestation of various autoimmune diseases and can lead to severe visual impairment. Hydroxychloroquine (HCQ) is an antimalarial drug that is also used to treat autoimmune diseases. The aim of this study was to investigate the association between HCQ use and the incidence of uveitis in patients with autoimmune diseases, as well as to identify potential risk factors for the development of uveitis in this study.MethodsWe conducted a population‐based cohort study using a nationwide database to investigate the incidence of uveitis in patients with autoimmune diseases who received HCQ treatment. We selected non‐HCQ comparison cohort at a 1:1 ratio by propensity score matching on age, sex, index date, urbanization, income, comorbidities, and medications. The data were analyzed using Cox proportional hazards models, and propensity score matching (PSM) was used to reduce selection bias.ResultsOur study included 15 822 patients with autoimmune diseases. After 1:1 PSM, there were 4555 individuals in both the HCQ group (n = 4555) and the non‐HCQ group (n = 4555). The multiple Cox proportional hazard regression analysis was used for the estimation of adjusted hazard ratios on uveitis. After PSM, the adjusted hazard ratio for the HCQ group was 0.74 (95% CI = 0.58–0.95). These findings suggest that HCQ may play a protective role in reducing the risk of uveitis in patients with autoimmune diseases, including rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus groups. The Kaplan–Meier survival curves also showed a significantly lower incidence of uveitis in the HCQ group (log‐rank = 0.0229) after PSM.ConclusionHCQ use is associated with a lower incidence of uveitis in patients with autoimmune diseases. Further studies are needed to confirm this association and to investigate the underlying mechanisms.

Publisher

Wiley

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