Hydroxychloroquine on the Pulmonary Vascular Diseases in Interstitial Lung Disease: Immunologic Effects, and Virus Interplay

Jun-Jun Yeh; Shih-Hueh Syue; Yi-Fun Sun; Yi-Ting Yeh; Ya-Chi Zheng; Cheng-Li Lin; Chung Y Hsu; Chia-Hung Kao

doi:10.3390/biomedicines10061290

Hydroxychloroquine on the Pulmonary Vascular Diseases in Interstitial Lung Disease: Immunologic Effects, and Virus Interplay

Biomedicines. 2022 May 31;10(6):1290. doi: 10.3390/biomedicines10061290.

Authors

Jun-Jun Yeh^{1

2}, Shih-Hueh Syue³, Yi-Fun Sun³, Yi-Ting Yeh³, Ya-Chi Zheng³, Cheng-Li Lin^{2

4}, Chung Y Hsu², Chia-Hung Kao^{5

6

7

8}

Affiliations

¹ Department of Family Medicine, Geriatric Medicine, Chest Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan.
² College of Medicine, China Medical University, Taichung 406040, Taiwan.
³ Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan.
⁴ Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan.
⁵ Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 406040, Taiwan.
⁶ Department of Nuclear Medicine and PET Center, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan.
⁷ Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan.
⁸ Center of Augmented Intelligence in Healthcare, China Medical University Hospital, China Medical University, Taichung 406040, Taiwan.

Abstract

To investigate the effects of hydroxychloroquine (HCQ) drug use on the risk of pulmonary vascular disease (PVD) in an interstitial lung disease cohort (ILD cohort, ILD+ virus infection), we retrospectively enrolled the ILD cohort with HCQ (HCQ users, N = 4703) and the ILD cohort without HCQ (non-HCQ users, N = 4703) by time-dependence after propensity score matching. Cox models were used to analyze the risk of PVD. We calculated the adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for PVD after adjusting for sex, age, comorbidities, index date and immunosuppressants, such as steroids, etc. Compared with the HCQ nonusers, in HCQ users, the aHRs (95% CIs) for PVD were (2.24 (1.42, 3.54)), and the women’s aHRs for PVD were (2.54, (1.49, 4.35)). The aHRs based on the days of HCQ use for PVD of 28−30 days, 31−120 days, and >120 days were (1.27 (0.81, 1.99)), (3.00 (1.81, 4.87)) and (3.83 (2.46, 5.97)), respectively. The medium or long-term use of HCQ or young women receiving HCQ were associated with a higher aHR for PVD in the ILD cohort. These findings indicated interplay of the primary immunologic effect of ILD, comorbidities, women, age and virus in the HCQ users.

Keywords: hydroxychloroquine (HCQ); interstitial lung disease (ILD); pulmonary vascular disease (PVD).

Grants and funding

This research received no external funding.