Publication:

Efficacy of hydroxychloroquine as a potential antidiabetic drug

Background India is the world’s diabetic capital. Oral antidiabetic therapy is still incomplete. Prior studies have shown that hydroxychloroquine (HCQ), a commonly used antimalarial, anti-rheumatic drug reduces the risk of developing diabetes mellitus. It probably acts by decreasing insulin metabolism- a novel mechanism of action.

Methods A systematic search was done in MEDLINE database with key words ‘Type 2 Diabetes Mellitus’, ‘Hydroxychloroquine’. Articles assessing the antidiabetic efficacy of hydroxychloroquine were reviewed and their results summarized.

Results With extensive literature search, we found out three RCTs and four Cohort studies assessing the efficacy of HCQ on glycaemic markers in patients with type 2 diabetes mellitus. Two randomized controlled trials done by Gerstein H C et al, Pareek A et al, comparing hydroxychloroquine with established antidiabetic drugs showed that there is significant reduction in glycaemic parameters with comparable similarity in both the groups (HbA1c: -0.91%±0.4%). Solomon et al in their study on patients with RA concluded that HCQ improved insulin sensitivity. Two cohort studies by Chen Y M et al and Wasko MCM et al respectively showed reduced incidence of diabetes mellitus in Systemic lupus erythematosus (Hazard ratio=0.26) and rheumatologic disease (relative risk=0.23) patients who received hydroxychloroquine. In a cohort study by Rekedal LR et al, HCQ reduced HbA1c by 0.66% compared to baseline in patients with RA. These studies also showed that hydroxychloroquine has favourable effect on lipid profile and good tolerabilityConclusions: Hydroxychloroquine has a potential to enter antidiabetic armamentarium due to its efficacy and low toxicity profile. More studies are required to confirm this.