Can Hydroxychloroquine (Plaquenil) help with arthritis?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

Plaquenil (hydroxychloroquine) is a valuable treatment option for certain types of arthritis, particularly rheumatoid arthritis and systemic lupus erythematosus, as it helps reduce pain, swelling, and joint damage, and is considered safe at proper doses with appropriate eye screening 1.

Key Points

  • Plaquenil is commonly prescribed for rheumatoid arthritis and systemic lupus erythematosus, where it helps reduce inflammation and modulate the immune system, slowing disease progression in autoimmune forms of arthritis.
  • The typical dose ranges from 200-400 mg daily, often taken once or twice a day with food to minimize stomach upset, and patients usually begin to notice improvement after 4-12 weeks of consistent use, though full benefits may take up to 6 months.
  • Regular eye exams are necessary while taking Plaquenil due to rare but serious risks of retinal damage with long-term use, and blood tests to monitor liver and kidney function are also recommended.
  • Plaquenil is often used as part of a comprehensive treatment approach that may include other medications, physical therapy, and lifestyle modifications, and is conditionally recommended over other conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for DMARD-naive patients with low disease activity 1.

Treatment Approach

  • The goal of treatment is to achieve remission and prevent structural damage and long-term disability, and Plaquenil can be used in combination with other DMARDs, such as methotrexate and sulfasalazine, to achieve this goal 1.
  • The American College of Rheumatology recommends a treat-to-target approach, where treatment is adjusted to minimize disease activity and achieve a predefined target, such as low disease activity or remission, and Plaquenil can be an effective part of this approach 1.

From the FDA Drug Label

The mechanisms underlying the anti-inflammatory and immunomodulatory effects of hydroxychloroquine sulfate in the treatment of rheumatoid arthritis, chronic discoid lupus erythematosus and systemic lupus erythematosus are not fully known. Hydroxychloroquine sulfate, USP is an antimalarial and antirheumatic drug Rheumatoid Arthritis, Systemic Lupus Erythematosus and Chronic Discoid Lupus Erythematosus

Plaquenil (hydroxychloroquine) can help with arthritis, specifically:

  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Chronic discoid lupus erythematosus The exact mechanisms of how it helps are not fully known 2.

From the Research

Plaquenil and Arthritis

Plaquenil, also known as hydroxychloroquine (HCQ), is a medication that has been used to treat various forms of arthritis, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The evidence suggests that HCQ can be beneficial in reducing the symptoms of arthritis and improving patient outcomes.

Benefits of HCQ in Arthritis Treatment

  • HCQ has been shown to reduce the production of pro-inflammatory cytokines, which contribute to the development of arthritis symptoms 3, 4.
  • HCQ has been found to improve blood lipids and glycated haemoglobin levels, which can help reduce the risk of cardiovascular disease in patients with arthritis 5.
  • HCQ has been shown to slow disease progression and enhance the effects of other medications, such as methotrexate, in treating RA 6.
  • HCQ has been found to mitigate RA-related cardiovascular and kidney conditions 6.

Safety and Side Effects

  • HCQ has been found to have a good safety profile, with rare but potential side effects including retinopathic adverse effects 6.
  • The risk of side effects can be minimized by close attention to dosage and regular monitoring of patients 3.

Use of HCQ During the COVID-19 Pandemic

  • The use of HCQ for COVID-19 treatment did not result in significant shortages for patients with RA and SLE 7.
  • The incidence of HCQ use increased dramatically in the general population during the pandemic, but usage rates returned to pre-pandemic trends in some countries 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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