Cavazzana I, Sala R, Bazzani C, Ceribelli A, Zane C, Cattaneo R, Tincani A, Calzavara-Pinton P G, Franceschini F
Rheumatology Unit and Chair - A.O. Spedali Civili di Brescia- Università degli Studi di Brescia, Italy.
Lupus. 2009 Jul;18(8):735-9. doi: 10.1177/0961203308101714.
To evaluate the efficacy of hydroxychloroquine (HCQ) and quinacrine (Qn) association, at two different dosages, in treatment of lupus skin lesions not responding to HCQ alone. Thirty-four patients, affected by cutaneous and systemic lupus erythematosus, were retrospectively analysed. They were treated by HCQ (5 mg/Kg/qd) and Qn with two regimens: 100 mg/qd (29 cases) and 50 mg/qd (5 cases). Discoid lupus erythematosus (19 cases), acute malar rash (6 cases), chilblain lupus (4 cases) showed a significant improvement with combination therapy (P = 0.009, P = 0.019, and P = 0.04, respectively). Ten patients with subacute cutaneous lupus showed a partial response, whereas lupus profundus didn't improve. The same overall response rate was recorded comparing two Qn regimens, but subjects taking 100 mg/qd improved more rapidly than the others (P = 0.001). Ten patients developed side effects, mainly represented by skin yellowish discolouration. Depression and severe headache with nausea, which were globally recorded in two cases, led to drug withdrawal. One additional case of hepatitis was recorded in a patient with preexisting Hepatitis C virus (HCV) infection. Combination of HCQ and Qn is rapidly effective at 100 mg/qd and well tolerated in the treatment of lupus skin lesions unresponsive to HCQ alone.
为评估羟氯喹（HCQ）与阿的平（Qn）联合使用两种不同剂量治疗对单独使用HCQ无反应的狼疮皮肤损害的疗效。对34例皮肤型和系统性红斑狼疮患者进行了回顾性分析。他们接受HCQ（5mg/kg/每日）和Qn两种方案治疗：100mg/每日（29例）和50mg/每日（5例）。盘状红斑狼疮（19例）、急性颧部皮疹（6例）、冻疮样狼疮（4例）联合治疗后有显著改善（分别为P = 0.009、P = 0.019和P = 0.04）。10例亚急性皮肤型狼疮患者有部分反应，而深部狼疮无改善。比较两种Qn方案时记录到相同的总有效率，但服用100mg/每日的患者比其他患者改善更快（P = 0.001）。10例患者出现副作用，主要表现为皮肤发黄。有两例患者总体出现抑郁和伴有恶心的严重头痛，导致停药。在一名既往感染丙型肝炎病毒（HCV）的患者中记录到另外一例肝炎病例。HCQ与Qn联合使用，每日100mg时起效迅速，对单独使用HCQ无反应的狼疮皮肤损害治疗耐受性良好。
