Association between cumulative dose of hydroxychloroquine and electrocardiographic abnormalities in patients with systemic lupus erythematosus

Autores de IDIVAL

• Jon Zubiaur Zamacola

  Autor

• Alba Herrero Morant

  Autor

• Adrian Margarida De Castro

  Autor

• Raquel Perez Barquin

  Autor

• 

  Javier Loricera García

  Autor

• 

  Ricardo Blanco Alonso

  Autor

Autores ajenos al IDIVAL

• Ferraz-Amaro I
• Castañeda S

Unidades

• INMUNOPATOLOGÍA

  

  Investigador Corresponsable

  Ricardo Blanco Alonso

Abstract

Objective: Hydroxychloroquine (HCQ) is one of the most used drugs in patients with systemic lupus erythema-tosus (SLE). In these patients, where heart involvement is common, cardiac HCQ toxicity may lead to fatal outcomes. The aim of this work is to study the influence of cumulative HCQ (cHCQ) in a selected group of patients with SLE and its association with electrocardiographic (EKG) abnormalities.Methods: Single-center retrospective, observational study in which data were collected from the medical records of consecutive patients with a diagnosis of SLE who started treatment with HCQ and who had a 12-lead EKG before starting treatment and during follow-up. EKG abnormalities were grouped as conduction or structural abnormalities. The association of cHCQ with the occurrence of EKG disturbances was analyzed together with other demographic and clinical variables through univariate and multivariate logistic regression models.Results: 105 patients were selected with median cHCQ of 913 g. The sample was classified into two groups, above or below 913 g. Significantly, more conduction disturbances were observed in the group above the median (OR: 2.89; 95%CI: 1.01-8.23). In the multivariate analysis, the OR per 100 g of cHCQ dose was 1.06 (95%CI: 0.99-1.14). Age was the only variable associated with conduction disturbances. There were no significant dif-ferences in the development of structural abnormalities and a tendency for more high-grade atrioventricular block was shown.Conclusion: Our study suggests an association between the cHCQ and the development of EKG conduction dis-turbances that disappears after multivariate adjustment. No increased number of structural abnormalities was observed.

Copyright © 2023. Published by Elsevier B.V.

Keywords

• Hydroxychloroquine; Systemic lupus erythematosus; Electrocardiogram; Cardiac conduction disturbances