AB0287 EFFECTS OF HYDROXYCHLOROQUINE ON PERIPHERAL BLOOD CYTOKINE EXPRESSION ASSOCIATED WITH ATHEROSCLEROSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: R. Wakiya, K. Ueeda, H. Shimada, S. Nakashima, M. Kato, M. Mahmoud Fahmy Mansour, T. Miyagi, K. Sugihara, Y. Ushio, M. Mizusaki, R. Senba, T. Kameda, H. Dobashi
Journal: Annals of the Rheumatic Diseases (2021)

Background: In systemic lupus erythematosus(SLE), a higher frequency of atherosclerotic lesions is associated with a poor life prognosis (1). Hydroxychloroquine (HCQ) has been reported to improve the prognosis of life and dyslipidemia in SLE (2), and the mechanism has been unclear. Objectives: To determine the effect of HCQ treatment on serum cytokines associated with atherosclerosis in SLE. Methods: SLE patients who received additional HCQ and maintained low disease activity between January 2016 and September 2020 were included in this study. Disease activity was assessed by SLEDAI, CLASI and LLDAS, and serum complement titers, anti-ds-DNA antibodies, serum insulin and serum cytokines (adiponectin, resistin and leptin) were analyzed before and after HCQ treatment. Results: Fifty-four patients (3 males, 51 females, mean age 41.9±12.8 years) were included (Table 1). Thirty-two patients achieved LLDAS at baseline. Serum adiponectin and insulin levels were significantly increased after 3 months of HCQ treatment compared to baseline, and serum resistin levels were significantly lower (Figure 1). Patients with a history of renal disease had greater degree of changes in serum adiponectin and resistin levels. Among SLE patients who did not achieve LLDAS at baseline, those who still did not achieve LLDAS after 3 months had significantly lower serum leptin levels before HCQ treatment than those who achieved it after 3 months. The change of serum resistin levels correlated with those of serum S100A8 levels (r=0.5, p=0.0001). Conclusion: Additional HCQ treatment in SLE patients improves lipid abnormalities. HCQ may improve prognosis by controlling disease activity in SLE and reducing risk factors for atherosclerosis. References: [1]Gregory Katz, et al. Systemic Lupus Erythematosus and Increased Prevalence of Atherosclerotic Cardiovascular Disease in Hospitalized Patients. Mayo Clin Proc. 2019; 94:1436-1443. [2]Laura Durcan, et al. Longitudinal Evaluation of Lipoprotein Parameters in Systemic Lupus Erythematosus Reveals Adverse Changes with Disease Activity and Prednisone and More Favorable Profiles with Hydroxychloroquine Therapy. J Rheumatol. 2016; 43: 745–750. Table 1. Characteristics of SLE patients enrolled in this study Characteristics n=54, no.(%) Female, no(%) 51(94) Age, years, mean±SD 41.9±12.8 Disease duration, years, mean±SD 15.1±11.1 Past involvement Renal involvement 23 (43) NPSLE 5 (9) Complication APS 10 (19) Dyslipidemia 2 (4) Diabetes 1 (2) Concomitant immunosuppressive treatments Prednisone No.(%) 46 (85) Median Dosage, mg/day (range) 5.0 (1-10) Disease activity SLENA-SLEDAI score 3.9±2.0 Current skin involvement 30 (56) anti-dsDNA positive, no(%) 21 (39) low complement, no(%) 29 (54) Anti-dsDNA positive means anti ds-DNA titer increases over 12 IU/ml Low complement means any of C3, C4 and CH50 decreases to less 68mg/dl, less 12mg/dl, 30U/ml. APS: Anti-phospholipid antibody syndrome, NPSLE: neuropsychiatric SLE, Disclosure of Interests: None declared