Stethoscope and clipboard with prescription
Antimalarials, such as hydroxychloroquine and chloroquine, are often prescribed to patients with lupus because of their efficacy and low toxicity. (Photo: iStock)

It's impossible to predict how the present will affect the future. Case in point: when World War II soldiers were given a drug to prevent malaria, a deadly tropical disease that was causing more deaths than the enemy, no one could have predicted that the drug would also be a safe and effective treatment for a lesser known autoimmune disease known as systemic lupus erythematosus (lupus).

Lupus is a disease in which the immune system attacks a number of organs including the skin, joints, lungs and kidneys. About 80 per cent of those afflicted with the disease develop skin rashes on sun-exposed areas of their body.

It was during the war that doctors noted that rashes associated with lupus cleared up when soldiers were treated with an antimalarial drug.  Since the discovery, several studies have gone on to show that antimalarial agents also prevent organ damage and improve survival in patients with lupus.

Krembil Emeritus Scientist Dr. Murray Urowitz's latest study provides further evidence of the safety and efficacy of antimalarial agents in treating lupus.

The five-year study investigated some of the long-term effects of antimalarial agents on lupus outcomes in three patient groups: those who took antimalarial drugs more than 60 per cent of the time; those who took antimalarial drugs less than 60 per cent of the time; and those who did not receive antimalarial drugs.

The three groups were regularly assessed for lupus symptoms, rates of disease flare ups, antimalarial drug related toxicity and the use of steroids to manage their symptoms.

The study results revealed that patients who consistently took antimalarial drugs had fewer lupus symptoms compared to those who did not. These patients also had noticeably fewer flare ups and needed lower cumulative doses of steroids. Importantly, only two study participants experienced adverse effects as a direct result of the antimalarial treatment.

"Our study highlights the importance of consistent intake of antimalarial agents early in the course of lupus," Dr. Urowitz explains. "It builds upon the discovery that was made decades ago, which first identified the benefits of antimalarial therapy in treating lupus."

This work was supported by the Lou and Marissa Rocca, the Lupus Foundation of Ontario and the Toronto General & Western Hospital Foundation.

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