A recent study presented at the American College of Rheumatology’s annual meeting has shed light on a potential benefit of treating rheumatoid arthritis (RA) with hydroxychloroquine (HCQ).
This research suggests that HCQ treatment may decrease the risk of nonalcoholic fatty liver disease (NAFLD), especially among individuals aged 50 and younger.
RA, an autoimmune disease, can lead to chronic joint inflammation and impact various organs, including the eyes, heart, and lungs.
While not a typical complication of RA, NAFLD affects a significant portion of RA patients, with about 35% of men and 22% of women affected.
Exploring the Link Between HCQ and NAFLD
Previous studies hinted at a potential connection between HCQ and a reduced risk of NAFLD. In light of this, rheumatologist Dr. Hsin-Hua Chen and a team from Taichung Veterans General Hospital in Taiwan decided to delve deeper into this association within a nationwide RA cohort.
The researchers analyzed population-based claims data from the National Health Insurance Research Database in Taiwan, covering the period from 2000 to 2020.
Their study involved over 21,000 patients, with an average age of 51.9 years, and a gender ratio of 3 women to 2 men.
To estimate the potential link between HCQ and NAFLD while accounting for potential factors, they utilized a time-varying, multivariable Cox regression model.
Subgroup analyses considered patients based on sex and age, specifically men and women aged both younger and older than 50.
Key Findings
The study revealed that 399 patients (1.86%) developed NAFLD after more than eight years. Notably, the research indicated that taking HCQ was associated with a significantly lower risk of NAFLD, particularly in women under the age of 50.
Dr. Chen suggested that this association may be attributed to HCQ’s effect on adiponectin, an adipokine inversely linked to insulin resistance, inflammation, and NAFLD.
It is proposed that HCQ’s ability to increase adiponectin levels may play a role in reducing NAFLD risk.
Additionally, the study identified other common risk factors for NAFLD, including obesity, higher doses of prednisone, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Limitations and Future Research
Despite these findings, the study has limitations, primarily related to the use of claims data.
Dr. Chen emphasized that potential confounding bias and detection bias cannot be entirely ruled out, and only a double-blind randomized controlled trial can definitively confirm HCQ’s effect on preventing or treating NAFLD.
In the interim, Dr. Chen recommended regular liver function tests every three months for all RA patients, with more frequent monthly tests for those taking medications known to have potential liver toxicity, such as methotrexate.
Conclusion
This study offers intriguing insights into the potential benefits of hydroxychloroquine in reducing the risk of nonalcoholic fatty liver disease in rheumatoid arthritis patients, particularly in younger women.
While further research is needed to confirm these findings, they underscore the importance of monitoring liver health in RA patients and exploring potential treatment options that address both their autoimmune condition and associated complications.
If you care about arthritis, please read studies about extra virgin olive oil for arthritis, and pomegranate: A natural treatment for rheumatoid arthritis.
For more information about arthritis, please see recent studies about how to live pain-free with arthritis, and results showing medical cannabis may help reduce arthritis pain, back pain.
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