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The antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) are used for treatment of skin and joint manifestations of systemic lupus erythematosus (SLE). However, treatment is sometimes discontinued in patients who are in remission or in those who have severe disease that requires more-significant immunosuppression. These authors conducted a systematic review of 95 randomized controlled or observational studies published between 1982 and 2007 to evaluate the efficacy and safety of antimalarials in the treatment of SLE. Case reports were included in the assessment of toxicity.
The quality of evidence that antimalarials reduce SLE activity and improve survival was graded as high. The strength of evidence for a protective effect on bone de…