Background/Purpose: Hydroxychloroquine (HCQ) has a disease-modifying effect in rheumatoid arthritis (RA) patients but also it is associated with improved lipid profile, and decreased risk for diabetes and cardiovascular events. However, the impact of early HCQ treatment in the long-term outcomes of RA is not well established. Therefore, we sought to determine the clinical manifestations, incident comorbidities, and functional status in a group of Hispanic patients with RA who received early therapy with HCQ.

Methods: A cross-sectional study was performed in a cohort of RA patients (per American College of Rheumatology classification criteria). Demographic features, health-related behaviors, cumulative RA manifestations, disease activity (per Disease Activity Score 28 [DAS-28]), functional status (per Health Assessment Questionnaire), incident comorbidities, and pharmacologic treatment were determined. Patients who received early treatment (within the first year from the onset RA symptoms), late treatment (>1 year from the onset of RA symptoms) or no treatment with HCQ were compared. All patients who were treated with HCQ received at least one year of therapy. Data were examined using bivariate and multivariate (logistic regression) analyses.

Results: A total of 419 patients were studied. The mean (SD) age of the study population was 56.0 (13.8) years and 87.3% were woman. The mean (SD) disease duration was 14.7 (9.1) years. Seventy-four (17.7%) patients received early treatment with HCQ, 131 (31.3%) late treatment with HCQ, and 214 (51.0%) patients did not receive therapy with HCQ. In the multivariate analysis adjusted for age and disease duration, those who received early treatment had lower HAQ scores (OR 0.59, 95% CI 0.41 – 0.85) and were less likely to have joint replacement surgeries (OR 0.15, 95% CI 0.03 – 0.67) than those who were not exposed to HCQ. These differences were not observed between patients who had late treatment and those who did not received HCQ treatment. No significant differences were observed between the three groups in terms of sex, lifestyle behaviors, joint deformities/contractures, extra-articular manifestations, current disease activity, incident comorbidities (arterial hypertension, diabetes mellitus, dyslipidemia, and cardiovascular events), and exposure to corticosteroids or other disease-modifying anti-rheumatic drugs (synthetic or biological).

Conclusion: In this group of Hispanic RA patients, those receiving early treatment with HCQ had better long-term outcomes, having less functional impairment and joint replacement surgeries than those who received late or no HCQ therapy. This study highlights the importance of early treatment with HCQ to prevent disease damage in RA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/early-treatment-with-hydroxychloroquine-is-associated-with-better-long-term-outcomes-in-a-group-of-hispanic-patients-with-rheumatoid-arthritis/