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Towards Understanding the Use of Hydroxychloroquine in Patients with Systemic Lupus Erythematosus

 

Scientific Study Title: 

 

Hydroxychloroquine in systemic lupus

 

Principal Investigators:

 

Sasha Bernatsky, MD, PhD, James McGll Professor, McGill University

Glen S Hazlewood, MD, PhD, FRCPC, Associate Professor, Division of Rheumatology, Cumming School of Medicine, University of Calgary ; Research Scientist, Arthritis Research Canada

 

Study Start Date: 

 

April 2018

 

Study End Date: 

 

March 2023

 

Why do this research?

 

Systemic lupus erythematosus (SLE) is a disease in which the immune system is overactive, causing inflammation in various organs including joints and skin. There are areas where better approaches in SLE could improve outcomes. One example relates to hydroxychloroquine (HCQ), a drug which can reduce the risk of serious disease flares. However, the main side effect of long-term use of HCQ is eye damage. At present, we cannot accurately predict which patients with SLE are most likely to have a flare of their SLE symptoms once we lower the dose of HCQ. Also, it is not clear what causes the risk of eye damage. Our study will fill these knowledge gaps and add information about patient preferences for HCQ use.

 

What will be done?

 

Our research will link and analyze data on 3,700 SLE patients across Canada to:

 

  1. evaluate factors associated with a poor outcome among patients with SLE who lower but do not stop HCQ (poor outcome being a significant increase in disease activity, hospitalization for SLE symptoms or need for increased therapy).
  2. determine factors associated with a poor outcome among patients with SLE who stop HCQ (poor outcome being a significant increase in disease activity, hospitalization for SLE symptoms or need for increased therapy).
  3. evaluate the relationship between HCQ use and occurrence of eye damage (retinal toxicity) in patients with SLE, and if it is associated with population characteristics and clinical characteristics.
  4. assess the preferences of patients with SLE for HCQ therapy and if preferences are associated with population characteristics and clinical factors. We will use interviews and a ‘discrete choice’ survey design.

 

Co-investigators:

 

Michal M Abrahamowicz, PhD, James McGill Professor of Biostatistics, McGill University; Research Scientist, Arthritis Research Canada

Susan Bartlett, PhD, Professor, Department of Medicine, Faculty of Medicine, McGill University

Ann E Clarke, MD, MSc, FRCPC, Professor, Division of Rheumatology, Department of Medicine, University of Calgary; Research Scientist, Arthritis Research Canada

Paul R Fortin, MD, MPH, FRCPC, Tenured Professor and Canada Research Chair on Systemic Autoimmune Rheumatic Diseases, Centre ARThrite – Université Laval; Senior Research Scientist, Arthritis Research Canada

John G Hanly, MD, FRCPC, Professor, Division of Rheumatology, Dalhousie University

Linda Li, BSc(PT), MSc, PhD, FCAHS, Professor, Department of Physical Therapy, University of British Columbia, Senior Research Scientist, Arthritis Research Canada

Christine A Peschken, MD, Professor, Division of Rheumatology, University of Manitoba

Evelyne Vinet, MD, PhD, Associate Professor, Department of Medicine, Faculty of Medicine, McGill University

 

Funding Agency:

 

Canadian Institutes of Health Research