Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus

Objective Hydroxychloroquine (HCQ) is a mainstay of therapy in the treatment of SLE. The effect of HCQ on platelets and vascular health is uncertain. We investigated the relationship between HCQ use and dose with platelet activity, platelet transcriptomics and vascular health in patients with SLE.Me...

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Main Authors: Peter Izmirly, H Michael Belmont, Jill P Buyon, MacIntosh Grant Cornwell, Elliot S Luttrell-Williams, Michael Golpanian, Hanane El Bannoudi, Khrystyna Myndzar, Stuart Katz, Nathaniel R Smilowitz, Alexis Engel, Robert Clancy, Kelly Ruggles, Jeffrey S Berger
Format: Article
Language:English
Published: BMJ Publishing Group 2021-04-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/8/1/e000475.full
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author Peter Izmirly
H Michael Belmont
Jill P Buyon
MacIntosh Grant Cornwell
Elliot S Luttrell-Williams
Michael Golpanian
Hanane El Bannoudi
Khrystyna Myndzar
Stuart Katz
Nathaniel R Smilowitz
Alexis Engel
Robert Clancy
Kelly Ruggles
Jeffrey S Berger
author_facet Peter Izmirly
H Michael Belmont
Jill P Buyon
MacIntosh Grant Cornwell
Elliot S Luttrell-Williams
Michael Golpanian
Hanane El Bannoudi
Khrystyna Myndzar
Stuart Katz
Nathaniel R Smilowitz
Alexis Engel
Robert Clancy
Kelly Ruggles
Jeffrey S Berger
author_sort Peter Izmirly
collection DOAJ
description Objective Hydroxychloroquine (HCQ) is a mainstay of therapy in the treatment of SLE. The effect of HCQ on platelets and vascular health is uncertain. We investigated the relationship between HCQ use and dose with platelet activity, platelet transcriptomics and vascular health in patients with SLE.Methods Platelet aggregation, platelet mRNA expression and vascular health (sublingual capillary perfused boundary region (PBR), red blood cell filling (RBCF) and brachial artery reactivity testing) were analysed by HCQ use and dose.Results Among 132 subjects with SLE (age: 39.7±12.9 years, 97% female), 108 were on HCQ. SLE disease activity was similar between subjects on and off HCQ. Platelet aggregation in response to multiple agonists was significantly lower in patients on HCQ. There were inverse relationships between HCQ dose and gene expression pathways of platelet activity. Gene expression of P-selectin (SELP) was inversely correlated with HCQ dose (r=−0.41, p=0.003), which was validated at the protein level. Subjects on HCQ had improved vascular function correlating with HCQ dose as measured by lower PBR (r=−0.52, p=0.007), higher RBCF (r=0.55, p=0.004) and greater brachial artery reactivity (r=0.43, p=0.056).Conclusion HCQ use was associated with decreased platelet activation and activation-related transcripts and improved vascular health in SLE.
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spelling doaj-art-7bf807a349284ed2a6c129d065fd930e2025-08-20T02:36:20ZengBMJ Publishing GroupLupus Science and Medicine2053-87902021-04-018110.1136/lupus-2021-000475Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosusPeter Izmirly0H Michael Belmont1Jill P Buyon2MacIntosh Grant Cornwell3Elliot S Luttrell-Williams4Michael Golpanian5Hanane El Bannoudi6Khrystyna Myndzar7Stuart Katz8Nathaniel R Smilowitz9Alexis Engel10Robert Clancy11Kelly Ruggles12Jeffrey S Berger132 Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York City, New York, USA2 Rheumatology, NYU Grossman School of Medicine, New York City, New York, USADivision of Rheumatology, Department of Medicine, New York University School of Medicine, New York City, New York, USAInstitute for Systems Genetics, NYU Langone Health, New York City, New York, USADivision of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USADivision of Rheumatology, Department of Medicine, New York University School of Medicine, New York City, New York, USADivision of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USADivision of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USADivision of Translational Medicine, New York University School of Medicine, New York City, New York, USADivision of Cardiology, NYU Langone Medical Center, New York, New York, USADivision of Rheumatology, Department of Medicine, New York University School of Medicine, New York City, New York, USADivision of Rheumatology, Department of Medicine, New York University School of Medicine, New York City, New York, USAInstitute for Systems Genetics, NYU Langone Health, New York City, New York, USADivision of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York City, New York, USAObjective Hydroxychloroquine (HCQ) is a mainstay of therapy in the treatment of SLE. The effect of HCQ on platelets and vascular health is uncertain. We investigated the relationship between HCQ use and dose with platelet activity, platelet transcriptomics and vascular health in patients with SLE.Methods Platelet aggregation, platelet mRNA expression and vascular health (sublingual capillary perfused boundary region (PBR), red blood cell filling (RBCF) and brachial artery reactivity testing) were analysed by HCQ use and dose.Results Among 132 subjects with SLE (age: 39.7±12.9 years, 97% female), 108 were on HCQ. SLE disease activity was similar between subjects on and off HCQ. Platelet aggregation in response to multiple agonists was significantly lower in patients on HCQ. There were inverse relationships between HCQ dose and gene expression pathways of platelet activity. Gene expression of P-selectin (SELP) was inversely correlated with HCQ dose (r=−0.41, p=0.003), which was validated at the protein level. Subjects on HCQ had improved vascular function correlating with HCQ dose as measured by lower PBR (r=−0.52, p=0.007), higher RBCF (r=0.55, p=0.004) and greater brachial artery reactivity (r=0.43, p=0.056).Conclusion HCQ use was associated with decreased platelet activation and activation-related transcripts and improved vascular health in SLE.https://lupus.bmj.com/content/8/1/e000475.full
spellingShingle Peter Izmirly
H Michael Belmont
Jill P Buyon
MacIntosh Grant Cornwell
Elliot S Luttrell-Williams
Michael Golpanian
Hanane El Bannoudi
Khrystyna Myndzar
Stuart Katz
Nathaniel R Smilowitz
Alexis Engel
Robert Clancy
Kelly Ruggles
Jeffrey S Berger
Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
Lupus Science and Medicine
title Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
title_full Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
title_fullStr Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
title_full_unstemmed Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
title_short Hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
title_sort hydroxychloroquine is associated with lower platelet activity and improved vascular health in systemic lupus erythematosus
url https://lupus.bmj.com/content/8/1/e000475.full
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