Publisher Information: Örebro universitet, Institutionen för medicinska vetenskaper Region Örebro län Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden; Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden Division of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden 2024
نبذة مختصرة : Background: Antimalarial agents (AMAs) are cornerstone drugs in the treatment of systemic lupus erythematosus (SLE), and their use has established benefits, such as improved prognosis and decelerated accrual of organ damage. The aim of this study was to investigate the frequency of discontinuation of AMAs and associated factors in a Swedish SLE population. Methods: We retrieved data from a regional SLE register where all patients fulfilled the 1982 ACR and/or the 2012 SLICC classification criteria. A total of 328 subjects were included in the analysis. Results: Altogether, 92.4% (303/328) had been prescribed AMAs at some point during their disease. At the last available visit, 67.7% (222/328) were currently prescribed AMAs. Among individuals who had discontinued use, 24.7% (20/81) had developed a contraindication. Side effects were also common reasons for discontinuation (n = 38); gastrointestinal symptoms (52.6%, 20/38) were most common. Patients who discontinued had accrued more organ damage at the last visit (mean SDI: 2.9; SD: 2.8) compared with those still on AMAs (mean SDI: 1.4; SD: 1.8; p = 0.001). Conclusions: Most patients had been exposed to AMAs, but 25% discontinued therapy. Among side effects leading to discontinuation, >50% were gastrointestinal, calling for adequate gastroprotection towards drug retention and prevention of organ damage progression.
This work has been supported by grants from the Swedish Research Council [2023-02256], the Swedish Rheumatism Association [R-939149 and R-969696], the Region Östergötland [RÖ-960604], the Gustafsson Foundation [2023-36 and 2021-26], the King Gustaf V’s 80-year Anniversary Foundation [FAI-2020-0663 and FAI-2020-0741), the King Gustaf V and Queen Victoria’s Freemasons Foundation [2021], Swedish Society of Medicine [SLS-974449], Nyckelfonden [OLL-974804], Professor Nanna Svartz Foundation [2021-00436], Region Stockholm [FoUI-955483] and Karolinska Institutet.
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