One Drug, Three Diseases

Robert W. Griffith, MD

It's not often that one drug can be found to help treat (or prevent) several diseases. Of course, aspirin comes to mind. But hydroxychloroquine (Plaqueril®) is another. Hydroxychloroquine started life as an antimalarial drug. It can be used to prevent malaria, or to treat it. More recently, the drug found use as a treatment for rheumatoid arthritis. As such, it's considered a disease-modifying drug - more powerful but with more serious side effects than the pain killers (non-steroid anti-inflammatory drugs, which are the first line of treatment). And now there's a report in the Journal of the American Medical Association that hydroxychloroquine-users have a reduced risk of developing type 2 diabetes.

Data from 4900 adults with rheumatoid arthritis were analyzed. About 1800 of them had taken hydroxychloroquine. During a follow-up period of more than 20 years cases of diabetes were determined, based on self-reports or the prescription of drugs to lower blood glucose levels. 54 diabetics from the hydroxychloroquine group developed diabetes, and 171 diabetics were found among those who had never taken the drug. This amounted to frequencies of 5.2% and 8.9% per 1000 patient-years, respectively. For those who had taken hydroxychloroquine for more than 4 years, the relative risk of developing diabetes was 23% that of those who had never taken it.

It may be that this preventive effect is not confined to people with rheumatoid arthritis. Some patients with systemic lupus erythematosus (SLE) also take hydroxychloroquine, and they have blood sugar and insulin changes similar to those found in the corresponding rheumatoid patients. The authors of the study suggest that further studies are needed to evaluate whether hydroxychloroquine should have a role as a preventive agent for diabetes in high-risk individuals in the general population. Truly an example of one drug, three diseases - and all of them seemingly unrelated.

Source
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