Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital Puli Branch, Nantou, Taiwan.
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.
Int J Rheum Dis. 2022 Dec;25(12):1424-1430. doi: 10.1111/1756-185X.14437. Epub 2022 Sep 11.
Hydroxychloroquine (HCQ), commonly used to treat patients with primary Sjögren's syndrome (pSS), has been shown to delay the development of systemic lupus erythematosus (SLE). This study aimed to explore the association between HCQ use and future development of SLE in pSS patients based on a nationwide nested case-control study.
Based on the National Health Insurance Research Database of Taiwan, those patients who were diagnosed with SLE at least 1 year after the diagnosis of pSS were identified as cases. Matched controls were randomly selected from pSS patients without a later diagnosis of SLE in a 1:10 ratio. The odds ratios (ORs) of HCQ exposure between cases and controls were analyzed by unconditional logistic regression after adjustment for age.
A cohort of 11 772 pSS patients were extracted from the database during the period from January 1, 2000 to December 31, 2010. A total of 111 (0.9%) pSS patients developed SLE during the follow-up period. Most (79%) of them developed SLE within 5 years after the diagnosis of pSS. There was no significant difference in the odds of HCQ exposure between cases and controls, with an adjusted OR of 2.43 (95% CI: 0.73-8.05). Neither did we observe a significant difference in the odds of exposure to a higher average dose of HCQ (≥100 mg/d vs non-exposed) between cases and controls in the sensitivity analysis.
Nearly 1% of pSS patients may develop SLE. HCQ use in pSS patients was not associated with a lower possibility of the future development of SLE.
羟氯喹（HCQ）常用于治疗原发性干燥综合征（pSS）患者，已被证实可延缓系统性红斑狼疮（SLE）的发生。本研究旨在通过一项全国性巢式病例对照研究，探讨 pSS 患者使用 HCQ 与 SLE 未来发展之间的关联。
基于台湾全民健康保险研究数据库，将至少在 pSS 诊断后 1 年被诊断为 SLE 的患者确定为病例。按照 1:10 的比例，从无 SLE 后续诊断的 pSS 患者中随机选择匹配对照。采用非条件 logistic 回归分析，在调整年龄后，分析病例组和对照组 HCQ 暴露的比值比（OR）。
从 2000 年 1 月 1 日至 2010 年 12 月 31 日期间，从数据库中提取了 11772 例 pSS 患者。在随访期间，共有 111 例（0.9%）pSS 患者发生 SLE。其中，大多数（79%）患者在 pSS 诊断后 5 年内发生 SLE。病例组和对照组 HCQ 暴露的可能性无显著差异，调整后的 OR 为 2.43（95%CI：0.73-8.05）。在敏感性分析中，我们也未观察到病例组和对照组之间 HCQ 暴露的平均剂量较高（≥100mg/d 与未暴露）的可能性存在显著差异。
近 1%的 pSS 患者可能会发展为 SLE。pSS 患者使用 HCQ 与 SLE 未来发生的可能性降低无关。
