USE OF HYDROXYCHLOROQUINE IN COMBINATION WITH STATINS AS AN LDL LOWERING AGENT IN PATIENTS OF TYPE II DM WITH DIABETIC NEPHROPATHY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 9
Abstract
BACKGROUND Statins have established themselves as one of the best choice for lowering LDL levels, and have recently been proved efficacious for reducing albuminuria significantly. However, with the latest bar for target LDL levels set at 50 mg/dl, we definitely need to look for other ways of lowering LDL especially in population of Diabetics Nephropathy who are not only at high risk for CV mortality but also need dosage reduction due to impaired renal function. With the recent DGI approval of HCQS (hydroxychloroquine) for use as an antidiabetic drug, we decided to explore the effects of HCQS in combination with atorvastatin on Lipid profile of patients with Diabetic Nephropathy. Our study showed that combining HCQS with Atorvastatin results in even better control of LDL levels with favourable effect on other lipids as well. MATERIALS AND METHODS This is a non -randomised controlled study. A total of 67 patients with Type II Diabetes Mellitus (in the age group of 30-80yrs, with clinical evidence of Diabetic Kidney Disease [DKD], HbA1c ≥ 6.5) were selected among admitted the patients of the K.P.S. P.G. Institute of Medicine at LLR & Associated Hospital, G.S.V.M. Medical College Kanpur and alternatively divided into two groups with one group taking Hydroxychloroquine (100mg b.i.d.) in addition to their regular medications. Both groups were then looked for any significant changes in their lipid profiles after 3 months. RESULTS In our study, while triglyceride levels were reduced by 24.69% and 10.66% in the Hydroxychloroquine and NonHydroxychloroquine group respectively, both of which were statistically significant, Low density Lipid-cholesterol levels were reduced by 10.24 % in Hydroxychloroquine group while these levels continued to increase by 14%, in the NONHydroxychloroquine group, after a follow up of 3 months. Also although the total cholesterol declined in both the groups after 3 months but, decline was more with HCQS group. And while HDL increased significantly with the HCQS group after 3 months, it was not significant in the NON-HCQS group. CONCLUSION While the NON-HCQS group (On atorvastatin 20mg alone) observed decline in TGs and Cholesterol, their HDL did not rise and LDL continued to rise after 3 months of treatment. However, in the HCQS group (On combination of HCQS 100mg bd and atorvastatin 20mg h/s ), HDL was seen increased with significant decline in LDL and TG after 3 months of treatment stating that the combination of HCQS with statins may be a better choice for lowering lipids in DKD patients than using statins alone.
Authors and Affiliations
Shri Krishna Gautam, Jitendra Singh Kushwaha, Harshit Khare, Brijesh Kumar
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