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  • HCQS advantageous in...

HCQS advantageous in children with proliferative lupus nephritis

Written By : Aditi |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-04-06T09:30:02+05:30  |  Updated On 6 April 2023 3:09 PM IST
HCQS advantageous in children with proliferative lupus nephritis
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A study published in the European Journal of Pediatrics has mentioned that HCQ improved the disease and LN activity in children with proliferative LN. The study also documented side effects like skin hyperpigmentation and mild retinal changes following HCQ usage.

It is already known that Hydroxychloroquine (HCQ) is an antimalarial agent. It manages mucocutaneous, musculoskeletal, and constitutional manifestations of systemic lupus erythematosus (SLE). There is a lack of data elucidating its side effects in children with a history of proliferative lupus nephritis (LN).

Considering this background, a study was conducted on 60 children with a history of proliferative LN classes III and IV treated with steroids and mycophenolate (MMF) regimens.

The study points could be summarised as follows:

  • The study had two groups: the HCQ and the placebo groups.
  • The HCQ group had 30 patients, and the placebo also had 30 patients.
  • They were evaluated initially at 6- and a 12-month follow-up by mucocutaneous, ophthalmological examination.
  • During the follow-up period, investigations were carried out on BUN, creatinine, 24 h proteinuria, triglycerides (TG), cholesterol, Antids-DNA, C3, and C4.
  • SLE disease activity index (SLEDAI-2 k) was used.
  • In the HCQ group, after 12 months, there was a significant decrease in Triglycerides, cholesterol, 24 h proteinuria, Antids-DNA, and SLEDAI score.
  • The cumulative probabilities of developing primary end-points (LN partial and complete remission) were 40% and 60% in the HCQ group versus 53.3% and 36.7% in the placebo after 12 months.
  • After 12 months, the HCQ group experienced mucocutaneous alopecia (3.3%), hyperpigmentation (10%), and ophthalmological mild retinal changes (6.7%), but they did not differ significantly from the placebo group.

The researchers said we demonstrated the percentage of patients LN class III, class IV, and IV-V. as 54 %, 43 % and 3 %, respectively. As shown by LEVY et al., classes III and IV were the most common.

They mentioned the complications of HCQ as mucocutaneous, involving alopecia 3.3%, hyperpigmentation 10%, and ophthalmological 7%.

This study has demonstrated the efficacy of HCQ in children with a history of proliferative LN, having advantages like rapid and sustained remission, antilipidemic effect, and rapid improvement of functions of the kidney. The side effects are fewer, like the pigmentation of skin and retinopathy.

Considering this, researchers have highly pointed out the importance of ophthalmological screening.

The study's limitations include small sample size, short flow-up duration, and non-monitoring of the cumulative doses of HCQ and serum levels.

Further reading:

Gheet, F.S., Dawoud, H.ES., El-Shahaby, W.A. et al. Hydroxychloroquine in children with proliferative lupus nephritis: a randomized clinical trial. Eur J Pediatr (2023). https://doi.org/10.1007/s00431-023-04837-0


hydroxychloroquineproliferating lupus nephritislupus nephritisLNsystemic lupus erythematosusSLELN class ILN class IILN class IIILN class IVeuropean journal of pediatrics
Source : European Journal of Pediatrics
Aditi
Aditi

    BDS, MDS in Periodontics and Implantology

    Dr. Aditi Yadav is a BDS, MDS in Periodontics and Implantology. She has a clinical experience of 5 years as a laser dental surgeon. She also has a Diploma in clinical research and pharmacovigilance and is a Certified data scientist. She is currently working as a content developer in e-health services. Dr. Yadav has a keen interest in Medical Journalism and is actively involved in Medical Research writing.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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