Effects of hydroxychloroquine on insulin sensitivity and lipid profile in patients with rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is associated with a decrease in insulin sensitivity (IS), which has been identified as an independent risk factor for the development of early atherosclerosis. Hydroxychloroquine (HCQ) may have beneficial effects on glucose homeostasis and lipid profile. Aim: To assess the effect of HCQ on IS and lipid profile in patients with RA. Material and Methods: An open clinical trial was performed in 15 patients aged between 35 and 56 years. During three months, patients received 400 mg/day of HCQ orally. Before and after the pharmacological intervention, demographic and anthropometric variables, serum glucose, total cholesterol (TC), triglycerides (TG), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, insulin and uric acid were measured. IS was estimated as the rate of glucose clearance per minute obtained with the insulin tolerance test (KITT). Results: Baseline and final KITT values were 4.3 +/- 1.2 and 4.80 +/- 1.1%/min, respectively (p = 0.03). Significant reductions in serum TC (p = 0.04) and TG (p = 0.01) were also observed. No other significant differences were observed. Conclusions: Oral administration of 400 mg/day of HCQ during three months in RA patients is associated with an improvement in IS, TC and TG.