{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T22:07:12Z","timestamp":1781129232692,"version":"3.54.1"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Systemic sclerosis (SSc) is a rare autoimmune disease with high mortality, often due to cardiopulmonary complications. Hydroxychloroquine (HCQ), commonly used in other rheumatic diseases, has immunomodulatory and potentially cardioprotective effects, but its role in SSc remains unclear. This study aimed to evaluate the association between HCQ use and the risk of mortality, ischemic heart disease (IHD), and pulmonary hypertension (PH) in a large real\u2010world SSc cohort.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study utilized de\u2010identified electronic medical records from the TriNetX Research network. Adults with an SSc diagnosis (ICD\u201010\u2010CM: M34) were divided into HCQ users and non\u2010users. After 1:1 propensity score matching for demographics, comorbidities and medications, outcomes including mortality, PH, acute myocardial infarction (MI), cerebral infarction, conduction heart disease, and myocarditis were assessed over 5\u2009years. Risk ratios (RR) and Kaplan\u2013Meier hazard ratios were calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of 17\u2009395 HCQ users and 58\u2009576 non\u2010users, 15\u2009485 propensity score matched pairs were analyzed. Over 5\u2009years, HCQ users showed higher PH (RR 1.124, 95% CI, 1.052\u20131.200,\n p<\/jats:italic>\n \u2009<\u20090.001) but lower mortality (RR 0.719, 95% CI, 0.674\u20130.767,\n p<\/jats:italic>\n \u2009<\u20090.001), indicating potential survival benefits. No significant differences were observed for IHD, MI, cerebral infarction, conduction disorders, or myocarditis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our research indicated that although patients on HCQ had a higher prevalence of PH, they exhibited lower mortality rates, suggesting a possible survival benefit. Further prospective studies are needed to explore these findings and clarify HCQ's role in SSC management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1756-185x.70515","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:09:38Z","timestamp":1770286178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Hydroxychloroquine on Mortality and Cardiovascular Outcomes in Systemic Sclerosis: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7170-9951","authenticated-orcid":false,"given":"Bal K.","family":"Subedi","sequence":"first","affiliation":[{"name":"Internal Medicine Jefferson Einstein Montgomery Hospital East Norriton Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Gautam","sequence":"additional","affiliation":[{"name":"General Medicine Gulmi Durbar Basic Hospital Gulmi Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafal","family":"Ali","sequence":"additional","affiliation":[{"name":"Rheumatology Jefferson Einstein Philadelphia Hospital Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0032-4000","authenticated-orcid":false,"given":"Irene J.","family":"Tan","sequence":"additional","affiliation":[{"name":"Rheumatology Jefferson Einstein Philadelphia Hospital Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S191418"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/kjm2.12505"},{"key":"e_1_2_9_4_1","volume-title":"StatPearls [Internet]","author":"Adigun R.","year":"2024"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-eular.3030"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2021.101668"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.86a.18109"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2018.76904"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2024-226430"},{"key":"e_1_2_9_10_1","unstructured":"S.Bellando\u2010Randone H.Wilhalme C.Bruni et\u00a0al. The Effect of Hydroxychloroquine on Activities of Daily Living and Hand Function in Systemic Sclerosis: Results From an Analysis of the EUSTAR Cohort."},{"key":"e_1_2_9_11_1","first-page":"319","article-title":"Cardiac Complications Attributed to Hydroxychloroquine: A Systematic Review of the Literature pre\u2010COVID\u201019","volume":"17","author":"Fram G.","year":"2021","journal-title":"Current Cardiology Reviews"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-025-04237-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2013.07.007"},{"key":"e_1_2_9_14_1","first-page":"1290","article-title":"Hydroxychloroquine on the Pulmonary Vascular Diseases in Interstitial Lung Disease: Immunologic Effects, and Virus Interplay","volume":"10","author":"Yeh J. J.","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-eular.850"}],"container-title":["International Journal of Rheumatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1756-185x.70515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1756-185x.70515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:34:54Z","timestamp":1773005694000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1756-185x.70515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/1756-185x.70515"],"URL":"https:\/\/doi.org\/10.1111\/1756-185x.70515","archive":["Portico"],"relation":{},"ISSN":["1756-1841","1756-185X"],"issn-type":[{"value":"1756-1841","type":"print"},{"value":"1756-185X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70515"}}