Treatment effectiveness of hydroxychloroquine in patients with primary Sjögren's syndrome: a real-world Study.

IF 2.8 3区医学 Q2 RHEUMATOLOGY

Clinical Rheumatology Pub Date : 2025-09-01 Epub Date: 2025-08-02 DOI:10.1007/s10067-025-07583-w

Kexin Zhu, Xueyi Zhang, Guangcai Chen, Ying Zhu, Kai Wang, Qing Zhang, Ziyi Jin, Qing Shu, Xiaojun Tang, Hongwei Chen, Dandan Wang, Wei Shen, Lingyun Sun

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引用次数: 0

Abstract

Objective: This study aimed to evaluate the effectiveness of hydroxychloroquine (HCQ) in reducing disease activity and explore its optimal dosing and combination therapies in patients with primary Sjögren's syndrome (pSS).

Methods: We conducted a retrospective study of 1089 hospitalized pSS patients. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Propensity score matching (PSM) was performed to assess robustness.

Results: Compared to non-users, patients receiving HCQ at daily doses of 300 mg (OR = 2.50, 95% CI 1.08-5.77), 400 mg (OR = 1.66, 95% CI 1.21-2.27), or > 5 mg/kg (OR = 1.71, 95% CI 1.25-2.34) showed higher response rates. Subgroup analyses suggested greater HCQ effectiveness in patients aged ≤ 50 years, without hypertension or diabetes, with SSA/RF seropositivity, no prior HCQ exposure, baseline ESSDAI scores of 5-13, concomitant glucocorticoids (GCs) use (> 20 mg/day), normal C3 level, or low C4 levels. The combination of GCs, cyclosporin A, and HCQ demonstrated a numerically higher response rate than GCs plus cyclosporin A alone (OR = 3.73, 95% CI 1.19-11.72). HCQ was associated with improved outcomes in thrombocytopenia (OR = 1.81, 95% CI 1.01-3.25), hypoalbuminemia (OR = 1.72, 95% CI 1.24-2.38), and elevated erythrocyte sedimentation rate (ESR) (OR = 2.25, 95% CI 1.42-3.58).

Conclusion: HCQ at daily doses of 300 mg, 400 mg, or > 5 mg/kg may reduce disease activity in pSS patients, particularly in specific subgroups. The combination of GCs, cyclosporin A, and HCQ warrants further investigation as a potential therapeutic strategy. HCQ might also benefit patients with thrombocytopenia, hypoalbuminemia, or elevated ESR. Key Points • A daily HCQ dosage of 300 mg, 400 mg or >5 mg/kg effectively reduced disease activity in pSS patients. • HCQ demonstrated therapeutic efficacy in specific pSS patient subgroups. • Glucocorticoids, cyclosporin A and HCQ may be a promising drug combination.

查看原文本刊更多论文

羟氯喹治疗原发性Sjögren综合征的有效性：一项真实世界的研究。

目的：本研究旨在评价羟氯喹（HCQ）降低原发性Sjögren综合征（pSS）患者疾病活动度的有效性，并探讨其最佳给药及联合治疗方案。方法：对1089例住院pSS患者进行回顾性研究。采用多变量logistic回归估计校正优势比（ORs），置信区间为95%。采用倾向评分匹配（PSM）来评估稳健性。结果：与未使用HCQ的患者相比，每日剂量300mg （OR = 2.50, 95% CI 1.08-5.77）、400mg （OR = 1.66, 95% CI 1.21-2.27）或bbb50mg /kg （OR = 1.71, 95% CI 1.25-2.34）的患者反应率更高。亚组分析显示，年龄≤50岁、无高血压或糖尿病、SSA/RF血清阳性、既往无HCQ暴露、基线ESSDAI评分在5-13分之间、同时使用糖皮质激素（GCs）（> - 20mg /天）、C3水平正常或C4水平低的患者使用HCQ效果更好。GCs、环孢素A和HCQ联合使用的有效率高于GCs +环孢素A单独使用（OR = 3.73, 95% CI 1.19-11.72）。HCQ与血小板减少（OR = 1.81, 95% CI 1.01-3.25）、低白蛋白血症（OR = 1.72, 95% CI 1.24-2.38）和红细胞沉降率（ESR）升高（OR = 2.25, 95% CI 1.42-3.58）的改善结果相关。结论：每日剂量300mg、400mg或bbb50 mg/kg的HCQ可降低pSS患者的疾病活动性，特别是在特定亚组中。GCs、环孢素A和HCQ联合使用作为一种潜在的治疗策略值得进一步研究。HCQ也可能对血小板减少症、低白蛋白血症或ESR升高的患者有益。•每日HCQ剂量为300 mg、400 mg或50 mg/kg，可有效降低pSS患者的疾病活动性。•HCQ在特定的pSS患者亚组中显示出治疗效果。•糖皮质激素、环孢素A和HCQ可能是一种很有前途的药物组合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Rheumatology 医学-风湿病学

CiteScore

6.90

自引率

2.90%

发文量

441

审稿时长

3 months

期刊介绍： Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level. The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.