紅斑性狼瘡病患使用氫氧奎寧與登革熱之風險

Association between Hydroxychloroquine Use and the Risk of Dengue in Patients With Systemic Lupus Erythematosus: A Nationwide, Population-based Case Control Study

目的：闡明系統性紅斑狼瘡患者中氫氧奎寧與登革熱的風險之間的關聯。方法：1997-2013年台灣全民健康保險研究資料庫中，有23,936名SLE患者。這之中有14名被診斷出登革熱（國際疾病分類第九版臨床修訂ICD-9-CM，代碼061）。我們根據性別、居住地、登革熱和SLE診斷日期來配對登革熱病例，以10：1的比例，隨機選擇了140名沒有感染登革熱的SLE患者，進行統計分析。結果：在登革熱診斷日期之前的3個月內，登革熱的風險與使用HCQ無關（OR, 0.46；95%CI，0.13-1.66；p = 0.237）。使用較低的HCQ劑量（≤200 mg /天）（OR, 0.52；95%CI，0.11-2.44；p = 0.409）。使用較高的HCQ劑量（>200 mg /天）（OR, 0.41，95%CI，0.09–1.93；p = 0.260）。結論：這項基於台灣全民健康保險研究資料庫的研究，並未證明HCQ的使用與登革熱的風險，在SLE患者之間存在顯著相關性。

Purpose: To determine the association between hydroxychloroquine (HCQ) and the risk of dengue in patients with systemic lupus erythematosus (SLE). Methods: Using claims data from the 1997–2013 Taiwan’s National Health Insurance Research Database, we identified 23,936 SLE patients. From them, we identified 14 patients who were diagnosed with dengue (International Classification of Diseases, Ninth Revision, Clinical Modification code 061). We randomly selected 140 SLE patients who did not have dengue to match dengue cases for sex, residence, date of dengue and SLE diagnosis; in a 10:1 ratio. We conducted univariable conditional logistic regression analyses to examine the associations of dengue with the baseline characteristics and SLE-related medications within 3 months before the index date, and identified those with a p-value of <0.15 as covariates in the multivariable analysis. We calculated the odds ratio (OR) with 95% confidence intervals (CI) using multivariable conditional logistic regression analyses to examine the association between HCQ use within 3 months and dengue.Results: The risk of dengue was not significantly associated with HCQ use within 3 months before the index date (OR, 0.46; 95% CI, 0.13–1.66; p = 0.237). We did not find a significant association between dengue risk either the use of lower HCQ doses (≤200 mg/day) (OR, 0.52; 95% CI, 0.11–2.44; p = 0.409) or the use of higher HCQ doses (> 200 mg/day) (OR, 0.41, 95% CI, 0.09–1.93; p = 0.260). Conclusions: This nationwide, population-based study did not demonstrate a significant association between the use of HCQ and the risk of dengue in SLE patients.