{
  "abstract": "Objective To evaluate the efficacy of mepacrine (MC) as an add-on therapy in patients with SLE unresponsive to hydroxychloroquine (HCQ)-containing regimens at 6 months after MC introduction.Methods Observational study using routine clinical care data of patients from the Lupus-Cruces cohort. All of them received therapy with HCQ and prednisone at baseline. Two groups of initial therapy were compared: single therapy (ST; HCQ + prednisone) and multiple therapy (MT; additional immunosuppressives or biologics). Achieving the definition of remission in SLE (DORIS) at 6 months was the main outcome. Prednisone tapering and MC side effects and discontinuation were also analysed. A logistic regression was performed in search of clinical predictors of response.Results 106 different episodes were included (ST=56, MT=50). The mean SLE Disease Activity Index (SLEDAI) at baseline was 6.7, with a mean prednisone dose of 6 mg/day. DORIS remission at 6 months was 71% for the complete cohort (ST 79% vs MT 62%, p=0.06). SLEDAI reduction at 6 months was similar in both groups (mean 4.6 points in the ST group vs 5 in the MT group, p=0.5). The reduction at 6 months was also similar (mean 1.75 mg/day in the ST group vs 1.69 mg/day in the MT group, p=0.9). The most frequent reason for MC discontinuation was improvement (45%). Adverse effects were reported in 17% patients.Conclusions MC is a useful therapy in mild–moderate active SLE. Using MC as the first drug after the failure of glucocorticoids and HCQ is the best option; however, the addition of MC to a multidrug regimen can also be of help.",
  "authors": [
    {
      "affiliations": [
        "Autoimmune Diseases Research Unit, Biobizkaia Health Research Institute, Barakaldo, Spain",
        "University of the Basque Country, Leioa, Spain"
      ],
      "name": "Beatriz Marín-García"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Research Unit, Biobizkaia Health Research Institute, Barakaldo, Spain"
      ],
      "name": "Luis Dueña-Bartolomé"
    },
    {
      "affiliations": [
        "University of the Basque Country, Leioa, Spain"
      ],
      "name": "Oihane Montero"
    },
    {
      "affiliations": [
        "Autoimmune Diseases Research Unit, Biobizkaia Health Research Institute, Barakaldo, Spain",
        "University of the Basque Country, Leioa, Spain"
      ],
      "name": "Guillermo Ruiz-Irastorza"
    }
  ],
  "title": "Combining mepacrine with hydroxychloroquine-based therapy in active systemic lupus erythematosus: an observational study of 106 patients from the Lupus-Cruces cohort",
  "uid": "118c4a53-1a67-572a-ae80-4aa35fda680d"
}