Effect of hydroxychloroquine on glucose control in patients with and without diabetes: a systematic review and meta-analysis of randomized controlled clinical trials

• Published in: European journal of clinical pharmacology Vol. 77; no. 11; pp. 1705 - 1712
• Main Authors: Simental-Mendía, Luis E., Simental-Mendía, Mario, Sánchez-García, Adriana, Linden-Torres, Enrique
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2021; Springer Nature B.V
• Subjects: Beta cells; Biomedical and Life Sciences; Biomedicine; Blood Glucose - drug effects; Clinical trials; Diabetes mellitus; Diabetes Mellitus, Type 2 - epidemiology; Fasting; Glucose; Glycated Hemoglobin A - drug effects; Hemoglobin; Humans; Hydroxychloroquine; Hydroxychloroquine - pharmacology; Insulin; Laboratory testing; Meta-analysis; Pharmacoepidemiology and Prescription; Pharmacology/Toxicology; Randomized Controlled Trials as Topic; Sensitivity analysis; Hydroxychloroquine; Glucose; Glycated hemoglobin; Insulin; Meta-analysis
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-021-03144-7

Purpose The aim of this meta-analysis of randomized controlled trials was to evaluate the effect of hydroxychloroquine on glucose control. Methods Randomized controlled trials examining the impact of hydroxychloroquine on glycemic markers were searched in PubMed, Web of Science, Scopus, and Google Scholar databases. Meta-analysis was performed using a random-effects model and sensitivity analysis through the leave-one-out method. Results Meta-analysis revealed a significant reduction of fasting glucose (WMD: − 8.05 mg/dl; 95% CI: − 11.17, − 4.93; I 2  = 75%; p ˂0.0001), 2-h postprandial glucose (WMD: − 15.52 mg/dl; 95% CI: − 20.61, − 10.42; I 2  = 53%; p ˂0.00001), and glycated hemoglobin (HbA1c) values (WMD: − 0.19%, 95% CI: − 0.37, − 0.02; I 2  = 94%; p  = 0.03) after hydroxychloroquine treatment. Otherwise, meta-analysis showed no significant effect of hydroxychloroquine on insulin levels (WMD: 16.52 μUI/ml; 95% CI: − 16.35, 49.40; I 2  = 90%; p  = 0.32) and HOMA-β (WMD: − 14.62; 95% CI: − 45.84, 16.59; I 2  = 0%; p  = 0.36). Conclusion The present meta-analysis revealed that treatment with hydroxychloroquine improves glucose control through the reduction of fasting glucose, 2-h postprandial glucose, and HbA1c values. Given that the effect of hydroxychloroquine on beta-cell function is based only on two clinical trials, it is not possible to draw definitive conclusions.