HCQ Pleiotropic Benefits SLE — SCE Rheumatology MCQ
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Correct answer: B — HCQ has multiple protective effects including: reduced flare rates reduced thrombotic risk (antiphospholipid protection) lipid-lowering cardiovascular protection bone-protective effects improved survival and potential anti-cancer effects
Hydroxychloroquine has remarkably broad pleiotropic benefits in SLE beyond disease activity control. These include: reduced flare frequency (approximately 50% reduction) improved survival (documented in multiple cohorts) reduced thrombotic risk (particularly relevant in aPL-positive patients through inhibition of antiphospholipid binding and platelet activation) favourable effects on lipid profile (reduces total cholesterol and LDL) anti-diabetic effects (improves insulin sensitivity) bone-protective properties prevention of irreversible organ damage accumulation (reduced SDI accrual) and potential anti-cancer effects. EULAR 2023 recommends HCQ for ALL SLE patients unless contraindicated and for as long as possible. This drug is the single most important medication in SLE management.
Reference: EULAR 2023 SLE; Ruiz-Irastorza G et al 2010 HCQ pleiotropic effects