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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Hospitalization 68% Improvement Relative Risk HCQ for COVID-19  Hidekawa et al.  Prophylaxis Does HCQ prophylaxis reduce infections? Retrospective study in Japan Lower hospitalization with HCQ (p=0.0066) Non-COVID-19, study analyzes all severe infections c19hcq.org Hidekawa et al., Frontiers in Immunology, Sep 2023 Favors HCQ Favors control

Protective effect of hydroxychloroquine on infections in patients with systemic lupus erythematosus: an observational study using the LUNA registry

Hidekawa et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1227403
Sep 2023  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19hcq.org
Non-COVID-19 study showing significantly lower risk of severe infections with HCQ among 925 SLE patients. Infections included pulmonary, urinary tract, skin and soft tissue, intra-abdominal, gastroenteritis, sepsis, infectious arthritis, and upper respiratory tract infections, with the most common being pneumonia.
risk of hospitalization, 67.8% lower, HR 0.32, p = 0.007, adjusted per study, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Hidekawa et al., 1 Sep 2023, Japan, peer-reviewed, 32 authors. Contact: yoshiryu@med.yokohama-cu.ac.jp.
This PaperHCQAll
Protective effect of hydroxychloroquine on infections in patients with systemic lupus erythematosus: an observational study using the LUNA registry
Chiharu Hidekawa, Ryusuke Yoshimi, Yusuke Saigusa, Jun Tamura, Noriko Kojitani, Naoki Suzuki, Natsuki Sakurai, Yuji Yoshioka, Yumiko Sugiyama-Kawahara, Yosuke Kunishita, Daiga Kishimoto, Kana Higashitani, Yuichiro Sato, Takaaki Komiya, Hideto Nagai, Naoki Hamada, Ayaka Maeda, Naomi Tsuchida, Lisa Hirahara, Yutaro Soejima, Kaoru Takase-Minegishi, Yohei Kirino, Nobuyuki Yajima, Ken-Ei Sada, Yoshia Miyawaki, Kunihiro Ichinose, Shigeru Ohno, Hiroshi Kajiyama, Shuzo Sato, Yasuhiro Shimojima, Michio Fujiwara, Hideaki Nakajima
Frontiers in Immunology, doi:10.3389/fimmu.2023.1227403
Objectives: Infection is a leading cause of death in patients with systemic lupus erythematosus (SLE). Alt hough hydroxychloroquine (HCQ) has been reported to inhibit infection, evidence from Asian populations remains insufficient. We investigated this effect in Japanese SLE patients. Methods: Data from the Lupus Registry of Nationwide Institutions were used in this study. The patients were ≥20 years old and met the American College of Rheumatology (ACR) classification criteria revised in 1997. We defined "severe infections" as those requiring hospitalization. We analyzed the HCQ's effect on infection suppression using a generalized estimating equation (GEE) logistic Frontiers in Immunology frontiersin.org 01
Ethics statement The studies involving humans were approved by the Institutional Review Board of Yokohama City University. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Author contributions Conception and design: RY. Data analysis and interpretation, drafting and editing of manuscripts: CH, RY, and HNak. Statistical analysis: YSai and JT. Patient follow-up, analysis and interpretation of data: NK, NSu, NSa, YY, YS-K, YKu, DK, KH, YSat, TK, HNag, NH, AM, NT, LH, YSo, KT-M, YKi, NY, K-ES, YM, KI, SO, HK, SS, YSh, and MF. Critical review of papers and approval of manuscripts: all authors. Conflict of interest KS received a speaker's fee from GlaxoSmithKline PLC and research grants from Pfizer Inc. YKi received a speaker's fee from Amgen and Novartis and research funding from Nippon Shinyaku. RY received a speaker's fee from GlaxoSmithKline PLC, AstraZeneca PLC, and Sanofi S.A. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that..
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{ 'DOI': '10.3389/fimmu.2023.1227403', 'ISSN': ['1664-3224'], 'URL': 'http://dx.doi.org/10.3389/fimmu.2023.1227403', 'abstract': '<jats:sec><jats:title>Objectives</jats:title><jats:p>Infection is a leading cause of death in ' 'patients with systemic lupus erythematosus (SLE). Alt hough hydroxychloroquine (HCQ) has been ' 'reported to inhibit infection, evidence from Asian populations remains insufficient. We ' 'investigated this effect in Japanese SLE ' 'patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data from the ' 'Lupus Registry of Nationwide Institutions were used in this study. The patients were ≥20 ' 'years old and met the American College of Rheumatology (ACR) classification criteria revised ' 'in 1997. We defined “severe infections” as those requiring hospitalization. We analyzed the ' 'HCQ’s effect on infection suppression using a generalized estimating equation (GEE) logistic ' 'regression model as the primary endpoint and performed a survival analysis for the duration ' 'until the first severe ' 'infection.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Data from 925 ' 'patients were used (median age, 45 [interquartile range 35–57] years; female, 88.1%). GEE ' 'analysis revealed that severe infections were significantly associated with glucocorticoid ' 'dose (odds ratio [OR] 1.968 [95% confidence interval, 1.379–2.810], ' '<jats:italic>p</jats:italic>&amp;lt;0.001), immunosuppressants (OR 1.561 [1.025–2.380], ' '<jats:italic>p</jats:italic>=0.038), and baseline age (OR 1.043 [1.027–1.060], ' '<jats:italic>p</jats:italic>&amp;lt;0.001). HCQ tended to suppress severe infections, ' 'although not significantly (OR 0.590 [0.329–1.058], <jats:italic>p</jats:italic>=0.077). ' 'Survival time analysis revealed a lower incidence of severe infections in the HCQ group than ' 'in the non-HCQ group (<jats:italic>p</jats:italic>&amp;lt;0.001). In a Cox proportional ' 'hazards model, baseline age (hazard ratio [HR] 1.029 [1.009–1.050], ' '<jats:italic>p</jats:italic>=0.005) and HCQ (HR 0.322 [0.142–0.728], ' '<jats:italic>p</jats:italic>=0.006) were significantly related to ' 'incidence.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>HCQ may ' 'help extend the time until the occurrence of infection complications and tends to decrease ' 'infection rates.</jats:p></jats:sec>', 'alternative-id': ['10.3389/fimmu.2023.1227403'], 'author': [ {'affiliation': [], 'family': 'Hidekawa', 'given': 'Chiharu', 'sequence': 'first'}, {'affiliation': [], 'family': 'Yoshimi', 'given': 'Ryusuke', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Saigusa', 'given': 'Yusuke', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Tamura', 'given': 'Jun', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kojitani', 'given': 'Noriko', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Suzuki', 'given': 'Naoki', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Sakurai', 'given': 'Natsuki', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Yoshioka', 'given': 'Yuji', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Sugiyama-Kawahara', 'given': 'Yumiko', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kunishita', 'given': 'Yosuke', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kishimoto', 'given': 'Daiga', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Higashitani', 'given': 'Kana', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Sato', 'given': 'Yuichiro', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Komiya', 'given': 'Takaaki', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Nagai', 'given': 'Hideto', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Hamada', 'given': 'Naoki', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Maeda', 'given': 'Ayaka', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Tsuchida', 'given': 'Naomi', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Hirahara', 'given': 'Lisa', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Soejima', 'given': 'Yutaro', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Takase-Minegishi', 'given': 'Kaoru', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kirino', 'given': 'Yohei', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Yajima', 'given': 'Nobuyuki', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Sada', 'given': 'Ken-ei', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Miyawaki', 'given': 'Yoshia', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Ichinose', 'given': 'Kunihiro', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Ohno', 'given': 'Shigeru', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kajiyama', 'given': 'Hiroshi', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Sato', 'given': 'Shuzo', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Shimojima', 'given': 'Yasuhiro', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Fujiwara', 'given': 'Michio', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Nakajima', 'given': 'Hideaki', 'sequence': 'additional'}], 'container-title': 'Frontiers in Immunology', 'container-title-short': 'Front. 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'key': 'B19', 'volume': '60', 'year': '2021'}, { 'DOI': '10.1177/0961203319860579', 'article-title': 'Factors predictive of serious infections over time in systemic lupus ' 'erythematosus patients: data from a multi-ethnic, multi-national, Latin ' 'American lupus cohort', 'author': 'Pimentel-Quiroz', 'doi-asserted-by': 'publisher', 'journal-title': 'Lupus', 'key': 'B20', 'volume': '28', 'year': '2019'}, { 'DOI': '10.1007/s10067-021-05988-x', 'article-title': 'Antimalarial treatment and minimizing prednisolone are associated with ' 'lower risk of infection in SLE: a 24-month prospective cohort study', 'author': 'Prata', 'doi-asserted-by': 'publisher', 'journal-title': 'Clin Rheumatol', 'key': 'B21', 'volume': '41', 'year': '2022'}, { 'DOI': '10.1186/s12916-016-0673-8', 'article-title': 'Risk of serious infections with immunosuppressive drugs and ' 'glucocorticoids for lupus nephritis: a systematic review and network ' 'meta-analysis', 'author': 'Singh', 'doi-asserted-by': 'publisher', 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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