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Randomized Controlled Trial
. 2020 Jan 1;59(1):107-111.
doi: 10.1093/rheumatology/kez242.

Hydroxychloroquine treatment downregulates systemic interferon activation in primary Sjögren's syndrome in the JOQUER randomized trial

Iris L A Bodewes  1 , Jacques-Eric Gottenberg  2 , Cornelia G van Helden-Meeuwsen  1 , Xavier Mariette  3 , Marjan A Versnel  1
Affiliations
Randomized Controlled Trial

Hydroxychloroquine treatment downregulates systemic interferon activation in primary Sjögren's syndrome in the JOQUER randomized trial

Iris L A Bodewes et al. Rheumatology (Oxford). .

Abstract

Objective: HCQ is frequently used to treat primary SS (pSS), but evidence for its efficacy is limited. HCQ blocks IFN activation, which is present in half of the pSS patients. The effect of HCQ treatment on the expression of IFN-stimulated genes (ISGs) was studied in pSS. Furthermore, HCQ-treated patients were stratified based on IFN activation and differences in disease activity and clinical parameters were studied.

Methods: Expression of ISGs and IFN scores was determined in 77 patients, who were previously enrolled in the placebo-controlled JOQUER trial. Patients were treated for 24 weeks with 400 mg/d HCQ or placebo.

Results: HCQ treatment reduced IFN scores and expression of ISGs compared with the placebo-treated group. HCQ reduced ESR, IgG and IgM levels independently of the patients' IFN activation status. No differences in EULAR SS disease activity index or EULAR SS patient reported index scores were observed after HCQ treatment, even after IFN stratification.

Conclusion: Treatment for 24 weeks with HCQ significantly reduced type I IFN scores and ISG-expression compared with the placebo-treated group. HCQ reduced several laboratory parameters, but failed to improve clinical response. This suggests that in pSS, type I IFN is associated to some laboratory parameters abnormalities, but not related to the clinical response.

Keywords: hydroxychloroquine; interferon; primary Sjögren’s syndrome.

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Figures

<sc>Fig</sc>. 1
Fig. 1
Disease activity of HCQ-treated pSS patients with (n = 19) or without (n = 18) IFN activation at baseline Median values of the EULAR SS Disease Activity Index (ESSDAI) (A), EULAR SS Patients Reported Index (ESSPRI) (B), and its subdomains dryness (C), fatigue (D) and pain (E) are reported at week 0, 12, 24 and 48.
See this image and copyright information in PMC

Comment in

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