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Research ArticleArticle
Open Access

Use of Hydroxychloroquine and Risk of Heart Failure in Patients With Rheumatoid Arthritis

Ahmed A. Sorour, Reto D. Kurmann, Youssef E. Shahin, Cynthia S. Crowson, Sara J. Achenbach, Rekha Mankad and Elena Myasoedova
The Journal of Rheumatology January 2021, jrheum.201180; DOI: https://doi.org/10.3899/jrheum.201180
Ahmed A. Sorour
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Reto D. Kurmann
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Youssef E. Shahin
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Cynthia S. Crowson
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Sara J. Achenbach
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Rekha Mankad
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Elena Myasoedova
This study was supported by grants from the National Institutes of Health/ National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 grants: AR046849, AG034676). A.A. Sorour, MD, R.D. Kurmann, MD, Y.E. Shahin, R. Mankad, MD, Department of Cardiovascular Medicine, Mayo Clinic; C.S. Crowson, PhD, Division of Biomedical Statistics and Informatics, and Department of Rheumatology, Mayo Clinic; S.J. Achenbach, MS, Division of Biomedical Statistics and Informatics, Mayo Clinic; E. Myasoedova, MD, PhD, Department of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA. The authors declare no conflicts of interest. Address correspondence to Dr. E. Myasoedova, Department of Rheumatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Email: myasoedova.elena@mayo.edu. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication January 8, 2021.
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Abstract

Objective To examine the relationship between the use of hydroxychloroquine (HCQ) and risk of developing heart failure (HF) in rheumatoid arthritis (RA).

Methods In this nested case-control study, cases were Olmsted County, Minnesota residents with incident RA (based on 1987 American College of Rheumatology criteria) from 1980 to 2013 who developed HF after RA incidence. Each case was matched on year of birth, sex, and year of RA incidence with an RA control who did not develop HF. Data on HCQ use including start and stop dates, as well as dose changes, were reviewed and used to calculate HCQ duration and cumulative dose. Age-adjusted logistic regression models were used to examine the association between HCQ and HF.

Results The study identified 143 RA cases diagnosed with HF (mean age 65.8 yrs, 62% females) and 143 non-HF RA controls (mean age 64.5, 62% female). HCQ cumulative dose was not associated with HF (OR 0.96 per 100-g increase in cumulative dose, 95% CI 0.90–1.03). Likewise, no association was found for patients with a cumulative dose ≥ 300 g (OR 0.92, 95% CI 0.41–2.08). The HCQ duration of intake in years prior to index was not associated with HF (OR 0.98, 95% CI 0.91–1.05).

Conclusion Use of HCQ was not associated with development of HF in patients with RA in this study. Further studies are needed to understand the effect of higher doses of HCQ on the development of HF in RA.

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The Journal of Rheumatology
Vol. 49, Issue 5
1 May 2022
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Use of Hydroxychloroquine and Risk of Heart Failure in Patients With Rheumatoid Arthritis
Ahmed A. Sorour, Reto D. Kurmann, Youssef E. Shahin, Cynthia S. Crowson, Sara J. Achenbach, Rekha Mankad, Elena Myasoedova
The Journal of Rheumatology Jan 2021, jrheum.201180; DOI: 10.3899/jrheum.201180

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Use of Hydroxychloroquine and Risk of Heart Failure in Patients With Rheumatoid Arthritis
Ahmed A. Sorour, Reto D. Kurmann, Youssef E. Shahin, Cynthia S. Crowson, Sara J. Achenbach, Rekha Mankad, Elena Myasoedova
The Journal of Rheumatology Jan 2021, jrheum.201180; DOI: 10.3899/jrheum.201180
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