Plaquenil: From Malaria Treatment to Managing Lupus, RA

To date, more than 30 current trials are underway to assess whether the addition of Plaquenil to standard chemotherapy improves cancer survival.

Improved Lives

Taken together, the portfolio of Plaquenil is impressive. We are indebted to the “fever tree,” the Cinchona tree of South America, for quinine and the subsequent development of Plaquenil. Medical science has given us a medication that improves the quality of our patients’ lives, year after year after year. Let us praise Plaquenil.

Charles Radis, DO, is a rheumatologist in Portland, Maine, and director of clinical research for Rheumatology Associates.

Acknowledgment

The author thanks Mary Chester M. Wasko, MD, MSc, director of the Rheumatology Division, West Penn Hospital, Allegheny Health Network, for her review assistance.

Editor’s note: The use of the brand name, Plaquenil, does not signify an endorsement of the product by the ACR or The Rheumatologist.

References

1. Duran-Reynals ML. The Fever Bark Tree: The Pageant of Quinine. Doubleday. 1946. 24.
2. Jaramillo-Arango JA. Critical review of the basic facts in the history of cinchona. Journal of the Linnean Society (Botany). 1949 Mar;53(352):272–311.
3. Delepine M. Joseph Pelletier and Joseph Caventou. Chem Educ. 1951;28(9):45.
4. Office of the Surgeon General: Circular letter No. 153: The drug treatment of malaria, suppressive and clinical. JAMA. 1943;123:205–208.
5. Goodman LS, Gilman A: The Pharmacological Basis of Therapeutics (ed 2). New York, Macmillan, 1954;1167–1173.
6. Page F. Treatment of lupus erythematosus with mecaprine. 1951. Lancet. 2:755–758.
7. Wallace DJ. The use of quinacrine (atabrine) in rheumatic diseases: A reexamination. Seminars in Arthritis and Rheumatism. 1989 May;18(4):282–297.
8. WHO Model List of Essential Medicines. October 2013. World Health Organization.
9. Motta M, Tincani A, Faden D, et al. Follow-up of infants exposed to hydroxychloroquine given to mothers during pregnancy and lactation. J Perinatol. 2005 Feb;25(2):86–89
10. Rahman P, Gladman DD, Urowitz MB, et al. The cholesterol lowering effect of antimalarial drugs is enhanced in patients with lupus taking corticosteroid drugs. J Rheumatol. 1999 Feb;26(2):325–330.
11. Morris SJ, Wasko MC, Antohe JL, et al. Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients. Arthritis Care Res (Hoboken). 2011 Apr;63(4):530–534.
12. Kerr G, Aujero M, Richards J, et al. Associations of hydroxychloroquine use with lipid profiles in rheumatoid arthritis: Pharmacologic implications. Arthritis Care and Research. 2014 Nov;66(11):1619–1626.
13. Quatraro A, Consoli G, Magno M, et al. Hydroxychloroquine in decompensated, treatment-refractory noninsulin-dependent diabetes mellitus: A new job for an old drug? Annals of Internal Medicine. 1990 May 1;112(9):678–681.
14. Wasko MC, Hubert HB, Lingala VB, et al. Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis. JAMA. 2007 Jul 11;298(2):187–193.
15. Rekedal LR, Massarotti E, Garg R, et al. Changes in glycosylated hemoglobin after initiation of hydroxychloroquine or methotrexate treatment in diabetes patients with rheumatic diseases. Arthritis Rheum. 2010 Dec;62(12):3569–3573.
16. Fangtham M, Petri M. 2013 update: Hopkins lupus cohort. Curr Rheum­atolol Rep. 2013 Sep;15(9):360.
17. Wu TK, Tsapogas MG, Jordan FR. Prophylaxis of deep venous thrombosis by hydroxychloroquine sulfate and heparin. Surg Gynecol Obstet. 1977 Nov;145(5):714–718.
18. Zhang W, et al. EULAR recommendations for calcium pyrophosphate deposition. Part II: Management. Annal Rheum Dis. 2011 Apr;70(4):571–575.
19. Marmor MF, Kellner U, Lai TY, et al. Revised recommendations on screening for chloroquine and hydroxy­chloroquine retinopathy. Ophthal­mology. 2011 Feb;118(2):415–422.
20. Melles RB, Marmor MF. The risk of toxic retinopathy in patients on long-term hydroxychloroquine. JAMA Ophthalmol. 2014 Dec;132(12):1453–1460.
21. Sui X, Chen R, et al. Autophagy and chemotherapy resistance: A promising therapeutic target for cancer treatment. Cell Death Dis. 2013 Oct 10;4:e838.