Evidence map›Paper›PMID 37498463›Full record

ArticleClinical rheumatology2024

Hydroxychloroquine use is associated with reduced mortality risk in older adults with rheumatoid arthritis.

Priyanka Iyer, Yubo Gao, Diana Jalal, Saket Girotra, Namrata Singh, Mary Vaughan-Sarrazin

Open access · greenAbstract read
In one paragraph

Article in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. The strategies and advances of mRNA translation booster.Asian journal of pharmaceutical sciences · 2025
    Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Priyanka IyerDivision of Rheumatology, University of California at Irvine, Irvine, CA, USA.
Yubo GaoDivision of General Medicine, Department of Internal Medicine, Roy and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Diana JalalDivision of Nephrology, Department of Internal Medicine, Roy and Lucille Carver College of Medicine, University of Iowa, and Iowa City VA Health Care System, Iowa City, IA, USA.
Saket GirotraDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Namrata SinghDivision of Rheumatology, Department of Medicine, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA. nasingh@uw.edu.ORCID http://orcid.org/0000-0001-7149-363X
Mary Vaughan-SarrazinDivision of General Medicine, Department of Internal Medicine, Roy and Lucille Carver College of Medicine, University of Iowa, and Iowa City VA Health Care System Center for Access and Delivery Research and Evaluation (CADRE), Iowa City, IA, USA.
University of Iowa · USSeattle Pacific University · USThe University of Texas Southwestern Medical Center · USUniversity of California, Irvine · US

Funding

Reducing Ethnic-racial Disparities in Cardiac Arrest Survival Outcomes (RED-CASO)R01HL160734 · NHLBI · SAINT LUKE'S HOSPITAL · PI CHAN, PAUL SHEUNG-YAN, GIROTRA, SAKET · 2022 to 2025
$2.6M
Peripheral Artery Disease: Long-term Survival & Outcomes Study (PEARLS)R01HL166305 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI Saket Girotra · 2023 to 2026
$2.5M
Peripheral Artery Disease: Long-term Survival & Outcomes Study (PEARLS)R56HL158803 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI GIROTRA, SAKET · 2021 to 2021
$633k
NHLBI NIH HHS R01 HL160734NHLBI NIH HHS R01 HL166305NHLBI NIH HHS R56 HL158803
6 · The paper itself

Abstract

backgroundThere is little robust data about the cardiovascular safety of hydroxychloroquine in patients with rheumatoid arthritis (RA), who often have cardiovascular comorbidities. We examined the association between use of hydroxychloroquine (HCQ) in patients with RA and major adverse cardiovascular events (MACE).

methodsIn a retrospective cohort of Medicare beneficiaries aged ≥ 65 years with RA, we identified patients who initiated HCQ (users) and who did not initiate HCQ (non-users) between January 2015-June 2017. Each HCQ user was matched to 2 non-users of HCQ using propensity score derived from patient baseline characteristics. The primary outcome was the occurrence of MACE, defined as acute admissions for stroke, myocardial infarction, or heart failure. Secondary outcomes included all-cause mortality and the composite of MACE and all-cause mortality. Cox proportional hazards model was used to compare outcomes between HCQ users to non-users.

resultsThe study included 2380 RA patients with incident HCQ use and matched 4633 HCQ non-users over the study period. The mean follow-up duration was 1.67 and 1.63 years in HCQ non-users and users, respectively. In multivariable models, use of HCQ was not associated with the risk of MACE (hazard ratio 1.1; 95% CI: 0.832-1.33). However, use of HCQ was associated with a lower risk of all-cause mortality (HR: 0.54; 95% CI: 0.45-0.64) and the composite of all-cause mortality and MACE (HR 0.67; 95% CI: 0.58-0.78).

conclusionHCQ use was independently associated with a lower risk of mortality in older adults with RA but not with incidence of MACE events. Key Points • Using an incident user design (to avoid the biases of a prevalent user design) and a population-based approach, we examined the effect of hydroxychloroquine (HCQ) on the risk of major cardiovascular events (MACE) in older patients with RA. • We did not find an association between HCQ use and incident MACE. We did, however, find a significant association with the composite outcome (MACE and all-cause mortality) driven by a significant reduction in all-cause mortality with HCQ use.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidMyocardial InfarctionAgedHumansHydroxychloroquineMedicareRetrospective StudiesUnited StatesAntirheumatic AgentsHydroxychloroquineCardiovascular eventsHydroxychloroquineMACERheumatoid arthritis

Identifiers

PMID37498463
PMCPMC10818008
OpenAlexW4385295011

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.