Antimalarials for SLE

Antimalarials for SLE

Antimalarial drugs (hydroxychloroquine and chloroquine) are used to manage the skin problems and inflammatory arthritis of SLE.

The mechanism of antimalarials in SLE is unclear. They may inhibit Il-1 production by macrophages, and responses and proliferation of T-cells. At high doses they have an inhibitory effect on DNA synthesis by inhibiting DNA-polymerase.

Short-term use of antimalarials is relatively safe, but may cause GI complaints, rashes and headache. However, because these agents have a slow titration schedule to avoid thrombocytopenia, they are rarely used short term. With high doses, the drug is stored in high concentrations in diverse organs (kidneys, liver, spleen etc.). In the eye this can result in retinopathy, decreased vision, and ultimately in blindness; in the nails is can lead to decolouration.

See also aminoquinolones in the chapter of infectious diseases.


Chloroquine can be used as therapy for various diseases. Which of the following is NOT an indication?