Cardiovascular Risks Associated With Hydroxychloroquine vs Methotrexate in Patients With Rheumatoid Arthritis
Journal of the American College of Cardiology

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This study was performed to evaluate the cardiovascular safety profile of hydroxychloroquine versus methotrexate in individuals with rheumatoid arthritis (RA). Among patients with RA with a history of heart failure, those who initiated hydroxychloroquine had a higher risk of multiple cardiovascular outcomes, including major adverse cardiovascular events (HR, 1.30), cardiovascular mortality (HR, 1.34), all-cause mortality (HR, 1.22), myocardial infarction (HR, 1.74), and hospitalization for heart failure (HR, 1.29) than those who initiated methotrexate.
Among patients with RA with no history of heart failure, those who initiated hydroxychloroquine had an increased risk of hospitalization than those who initiated methotrexate; no difference in cardiovascular risks was noted between the two groups.

Hydroxychloroquine should be used cautiously in patients with a history of heart failure owing to the increased risk of certain adverse cardiovascular outcomes.

G Mohan