A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune condition characterized by persistent, chronic inflammation that damages organ tissue. One of the symptoms that is often found in SLE is cognitive dysfunction. Hydroxychloroquine is recommended for the treatment of all levels of SLE. Th...

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Main Authors: Bantar Suntoko, Suharyo Hadisaputro, Handono Kalim, Suyanto Hadi, Ika Vemilia Warlisti
Format: Article
Language:English
Published: Secretariat of The Indonesian Biomedical Journal 2023-08-01
Series:Indonesian Biomedical Journal
Online Access:https://inabj.org/index.php/ibj/article/view/2504
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author Bantar Suntoko
Suharyo Hadisaputro
Handono Kalim
Suyanto Hadi
Ika Vemilia Warlisti
author_facet Bantar Suntoko
Suharyo Hadisaputro
Handono Kalim
Suyanto Hadi
Ika Vemilia Warlisti
author_sort Bantar Suntoko
collection DOAJ
description BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune condition characterized by persistent, chronic inflammation that damages organ tissue. One of the symptoms that is often found in SLE is cognitive dysfunction. Hydroxychloroquine is recommended for the treatment of all levels of SLE. This study was conducted to prove the influence of hydroxychloroquine on improving cognitive function and inflammatory biomarkers compared to standard therapy. METHODS: The study adopted randomized controlled trial (RCT) in SLE patients with cognitive dysfunction who met the inclusion criteria. The treatment group consisted of 26 subjects who received hydroxychloroquine 200 mg/day for 8 weeks and standard therapy, while the control group consisted of 29 subjects who were given standard therapy only. Examination of Montreal Cognitive Assessment (MoCA)-INA, interleukin (IL)-6, IL-4, interferon (IFN)-α, and C-reactive protein (CRP) scores was carried out at the beginning and the end of the study. The unpaired variables were examined with independent T-test or the Mann-Whitney test, while the paired variables were examined with paired T-test or Wilcoxon signed rank test. The Spearman correlation test was used to measure correlation between variables. RESULTS: A total of 55 subjects participated and completed the study. The result showed a significant relationship between hydroxychloroquine and decreasing levels of IL-6 and IL-4 (p<0.05). Meanwhile, there was no significant effect on the increase in cognitive function and decrease in IFN-α and CRP (p>0.05) in both groups. CONCLUSION: Hydroxychloroquine decreases the levels of IL-6 and IL-4, but has no effect on cognitive function, levels of IFN-α and CRP. KEYWORDS: hydroxychloroquine, systemic lupus erythematosus, cognitive dysfunction, inflammation
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spelling doaj.art-79b51eb7dbde4f2eb54e415511ec4d812023-08-25T01:22:10ZengSecretariat of The Indonesian Biomedical JournalIndonesian Biomedical Journal2085-32972355-91792023-08-011543546110.18585/inabj.v15i4.2504531A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in IndonesiaBantar Suntoko0Suharyo Hadisaputro1Handono Kalim2Suyanto Hadi3Ika Vemilia Warlisti4Doctoral Program of Medical and Health Science, Faculty of Medicine, Universitas Diponegoro, Jl. Dr. Sutomo No.16, Semarang 50244Division of Tropical Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro/Dr. Kariadi General Hospital, Jl. Dr. Sutomo No.16, Semarang 50244Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya/Dr. Saiful Anwar Hospital, Jl. Jaksa Agung Suprapto No.2, Malang 65112Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro/Dr. Kariadi General Hospital, Jl. Dr. Sutomo No.16, Semarang 50244Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro/Dr. Kariadi General Hospital, Jl. Dr. Sutomo No.16, Semarang 50244BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune condition characterized by persistent, chronic inflammation that damages organ tissue. One of the symptoms that is often found in SLE is cognitive dysfunction. Hydroxychloroquine is recommended for the treatment of all levels of SLE. This study was conducted to prove the influence of hydroxychloroquine on improving cognitive function and inflammatory biomarkers compared to standard therapy. METHODS: The study adopted randomized controlled trial (RCT) in SLE patients with cognitive dysfunction who met the inclusion criteria. The treatment group consisted of 26 subjects who received hydroxychloroquine 200 mg/day for 8 weeks and standard therapy, while the control group consisted of 29 subjects who were given standard therapy only. Examination of Montreal Cognitive Assessment (MoCA)-INA, interleukin (IL)-6, IL-4, interferon (IFN)-α, and C-reactive protein (CRP) scores was carried out at the beginning and the end of the study. The unpaired variables were examined with independent T-test or the Mann-Whitney test, while the paired variables were examined with paired T-test or Wilcoxon signed rank test. The Spearman correlation test was used to measure correlation between variables. RESULTS: A total of 55 subjects participated and completed the study. The result showed a significant relationship between hydroxychloroquine and decreasing levels of IL-6 and IL-4 (p<0.05). Meanwhile, there was no significant effect on the increase in cognitive function and decrease in IFN-α and CRP (p>0.05) in both groups. CONCLUSION: Hydroxychloroquine decreases the levels of IL-6 and IL-4, but has no effect on cognitive function, levels of IFN-α and CRP. KEYWORDS: hydroxychloroquine, systemic lupus erythematosus, cognitive dysfunction, inflammationhttps://inabj.org/index.php/ibj/article/view/2504
spellingShingle Bantar Suntoko
Suharyo Hadisaputro
Handono Kalim
Suyanto Hadi
Ika Vemilia Warlisti
A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
Indonesian Biomedical Journal
title A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
title_full A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
title_fullStr A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
title_full_unstemmed A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
title_short A Double-Blind, Randomized Controlled Trial of Hydroxychloroquine for Cognitive Dysfunction and Inflammatory Biomarkers in Systemic Lupus Erythematosus Patients in Indonesia
title_sort double blind randomized controlled trial of hydroxychloroquine for cognitive dysfunction and inflammatory biomarkers in systemic lupus erythematosus patients in indonesia
url https://inabj.org/index.php/ibj/article/view/2504
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