Treatment of ankylosing spondylitis with hydroxychloroquine
Hydroxychloroquine, an anti-inflammatory and immunomodulatory drug, is commonly prescribed by doctors to manage autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus [1]. The drug is available in 200-mg tablets, and its dosage is usually determined by a doctor [2].
While hydroxychloroquine has shown effectiveness in treating RA by preventing lysosomes from releasing inflammatory enzymes and cytokines, its role in managing another inflammatory condition, ankylosing spondylitis (AS), remains somewhat unclear [3].
Current research indicates that hydroxychloroquine is not among the most commonly used or highly ranked treatments for AS [4]. In fact, it ranks #27 out of 654 treatments tried for AS by patients, indicating it is used but not among front-line options like adalimumab, a tumor necrosis factor (TNF) inhibitor [4].
Although hydroxychloroquine may be considered occasionally, especially in cases where patients show positive antinuclear antibodies (ANA), it is not a primary treatment for AS inflammation or prevention of joint damage [5]. Most recent reviews focus on biologic disease-modifying antirheumatic drugs (bDMARDs), particularly TNF inhibitors and IL-17/IL-23 inhibitors, for effectively controlling AS disease activity and reducing inflammation [6][7].
Moreover, conventional DMARDs like hydroxychloroquine have a more heterogeneous and less well-established role, particularly regarding cardiovascular risk modulation in inflammatory joint diseases, including AS. The more significant impact is seen with biologics such as TNF inhibitors, which have documented benefits on inflammation, endothelial function, and possibly cardiovascular risk [7].
People taking hydroxychloroquine long term should get regular eye exams to monitor for potential side effects such as retinopathy, which can lead to vision loss [2]. Additionally, people with existing heart conditions and a higher risk of retinopathy may need to take additional precautions when taking hydroxychloroquine [8].
In summary, while hydroxychloroquine is effective in treating RA, its role in managing AS is less clear. Current research and scientific reviews suggest that hydroxychloroquine is not a frontline or highly effective treatment for AS. It may be considered in select cases, but other therapies, such as TNF inhibitors and IL-17/IL-23 inhibitors, are currently considered more effective for treating AS and related cardiovascular risks.
- Despite its success in managing rheumatoid arthritis (RA), the role of hydroxychloroquine in treating another inflammatory condition, ankylosing spondylitis (AS), is not well-defined.
- In the realm of medical-conditions, hydroxychloroquine ranks relatively low (#27) among the treatments attempted by AS patients, suggesting it is not one of the primary options like adalimumab, a TNF inhibitor.
- Hydroxychloroquine might be considered occasionally in AS cases where patients show positive antinuclear antibodies (ANA), but it's not a primary treatment for AS inflammation or prevention of joint damage.
- Recent reviews in science primarily focus on biologic disease-modifying antirheumatic drugs (bDMARDs), particularly TNF inhibitors and IL-17/IL-23 inhibitors, for effectively controlling AS disease activity and reducing inflammation.
- Conventional DMARDs like hydroxychloroquine have a less defined role in inflammatory joint diseases, including AS, compared to biologics such as TNF inhibitors, which have documented benefits on inflammation, endothelial function, and cardiovascular risk.
- Long-term hydroxychloroquine users should undergo regular eye exams to check for potential side effects like retinopathy, which could lead to vision loss.
- People with existing heart conditions and a higher risk of retinopathy may need to take extra precautions when taking hydroxychloroquine due to potential side effects.
