Incident Use of Hydroxychloroquine for the Treatment of Rheumatoid Arthritis and Systemic Lupus Erythematosus During the COVID-19 Pandemic

Nuria Mercade-Besora, Yuchen Guo, Mike Du, Xintong Li, Juan Manuel Ramirez-Anguita, Alberto Moreno, Antonio Valente, Felipe Villalobos, Iek Leng Cheng, Lucia A. Carrasco-Ribelles, Maaike M. H. van Swieten, Manon Merkelbach, Mary Magoya, Paolo Lasalvia, Pau Pericas-Pulido, Paul Berg, Pauline Bosco-Levy, Roberto Lillini, Rogerio Ribeiro, Trinamjot Kaur BaggaVittoria Ramella, Sara Khalid, Miguel Angel Mayer, Angela Leis, Annika M. Joedicke, Edward Burn, Daniel Prieto-Alhambra*, Marti Catala, Albert Prats-Uribe

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: We studied whether the use of hydroxychloroquine (HCQ) for COVID-19 resulted in supply shortages for patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods: We used US claims data (IQVIA PHARMETRICS® Plus for Academics [PHARMETRICS]) and hospital electronic records from Spain (Institut Municipal d'Assistència Sanitària Information System [IMASIS]) to estimate monthly rates of HCQ use between January 2019 and March 2022, in the general population and in patients with RA and SLE. Methotrexate (MTX) use was estimated as a control. Results: More than 13.5 million individuals (13,311,811 PHARMETRICS, 207,646 IMASIS) were included in the general population cohort. RA and SLE cohorts enrolled 135,259 and 39,295 patients, respectively, in PHARMETRICS. Incidence of MTX and HCQ were stable before March 2020. On March 2020, the incidence of HCQ increased by 9- and 67-fold in PHARMETRICS and IMASIS, respectively, and decreased in May 2020. Usage rates of HCQ went back to prepandemic trends in Spain but remained high in the United States, mimicking waves of COVID-19. No significant changes in HCQ use were noted among patients with RA and SLE. MTX use rates decreased during HCQ approval period for COVID-19 treatment. Conclusion: Use of HCQ increased dramatically in the general population in both Spain and the United States during March and April 2020. Whereas Spain returned to prepandemic rates after the first wave, use of HCQ remained high and followed waves of COVID-19 in the United States. However, we found no evidence of general shortages in the use of HCQ for both RA and SLE in the United States.

Original languageEnglish
Number of pages6
JournalArthritis Care & Research
Early online date25 Mar 2024
Publication statusE-pub ahead of print - 25 Mar 2024

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Publisher Copyright:
© 2024 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.


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