Yang Deng-Ho, Wang Yu-Hsun, Pan Lung-Fa, Wei James Cheng-Chung
Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung 411, Taiwan.
Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung 406, Taiwan.
J Clin Med. 2020 Oct 28;9(11):3469. doi: 10.3390/jcm9113469.
Sjögren's syndrome (SS) is a chronic systemic inflammation disease with clinical presentation of dry eye, dry mouth, and polyarthralgia. Active inflammation is associated with an increased risk of associated arterial stiffness or subclinical atherosclerosis-related cardiovascular events. We used the longitudinal health insurance database of Taiwan, which includes one million participants, to evaluate the relationship between the clinical medication of hydroxychloroquine (HCQ) and the development of coronary artery disease (CAD). In total, 1674 patients with SS receiving HCQ medication were included after exclusion for previous CAD. Altogether, 1142 SS patients were included for evaluation after follow-up for more than one year. After adjusting for age, gender, medications, and chronic comorbidities, a significantly decreased hazard ratio (HR) for developing CAD was found among SS patients with higher medication possession ratio (MPR) of HCQ (HR = 0.49, 95% confidence interval, CI: 0.26-0.94) when compared with low MPR of HCQ. A low HR for CAD was observed in SS patients with a high cumulative dose of at least 100,267 mg of HCQ (HR = 0.25, 95% CI: 0.09-0.66). Long-term HCQ therapy may decrease the HR of CAD in SS patients. The significant cardiovascular protective effect of HCQ therapy was observed in our study.
干燥综合征（SS）是一种慢性全身性炎症性疾病，临床表现为干眼症、口干症和多关节痛。活动性炎症与相关动脉僵硬度增加或亚临床动脉粥样硬化相关心血管事件的风险增加有关。我们使用了台湾的纵向健康保险数据库，该数据库包含100万名参与者，以评估羟氯喹（HCQ）的临床用药与冠状动脉疾病（CAD）发生之间的关系。在排除既往患有CAD的患者后，共纳入1674例接受HCQ治疗的SS患者。经过一年多的随访，共纳入1142例SS患者进行评估。在调整年龄、性别、用药情况和慢性合并症后，发现与低HCQ用药占有比例（MPR）的SS患者相比，高MPR的SS患者发生CAD的风险比（HR）显著降低（HR = 0.49，95%置信区间，CI：0.26 - 0.94）。在累积剂量至少为100267mg的高HCQ剂量的SS患者中观察到CAD的低HR（HR = 0.25，95%CI：0.09 - 0.66）。长期HCQ治疗可能会降低SS患者CAD的HR。在我们的研究中观察到HCQ治疗具有显著的心血管保护作用。
