Use Of Anti-Malarial drugs to treat Lupus
Two commonly used anti-malarial drugs hydroxychloroquine sulfate (Plaquenil) and chloroquine hydrochloride (Aralen) have become some of the two most commonly prescribed drugs for the treatment of Lupus. Although these drugs are not labeled by the U.S. Food and Drug Administration (FDA) for the treatment of lupus, they are often prescribed to people with lupus.
These medications work for Lupus patients by reducing inflammation. They are used much in the same way to treat and prevent Malaria. These medications are also used to control skin rash in people who have lupus. They may also help muscle and joint pain, fatigue, and fever that are not controlled with nonsteroidal anti-inflammatory drugs (NSAIDs).1
These medications may be used together with anti-inflammatory drugs or steroids. Using them may allow patients to reduce the dose of steroids to a level that causes fewer or less severe side effects.
Antimalarials may reduce the frequency of flare-ups and maintain remission in mild or inactive lupus when taken as maintenance therapy.
Although there are many pros to these drugs, they are not without side-effects. The most significant side effect is damage to the tissue that lines the eye (retina), but it is rare when low doses of the drug are taken. An initial eye exam will be done after three months of taking hydroxychloroquine sulfate (Plaquenil) or chloroquine hydrochloride (Aralen). After that regular eye tests are suggested using an at home test such as an Amsler Grid. If there is a change in eyesight, the doctor may reduce or discontinue use of the medication. Other side effects include occasional rash, nausea, or diarrhea. These medications are generally well tolerated.2
Another downside to these drugs is that it may take several months for these drugs to work. If the drug doesn't seem to be helping within six months, the doctor will probably discontinue it.
- Canadian Hydroxychloroquine Study Group (1991). A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus. New England Journal of Medicine, 324(3): 150–154.
- Hahn BH (1997). Management of systemic lupus erythematosus. In WN Kelley, et al., eds., Textbook of Rheumatology, 5th ed., vol. 2, pp. 1040–1056. Philadelphia: W.B. Saunders.