{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T09:29:45Z","timestamp":1778664585750,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,22]],"date-time":"2020-11-22T00:00:00Z","timestamp":1606003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01\u2010DK120518"],"award-info":[{"award-number":["R01\u2010DK120518"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["HHSH250201000018C"],"award-info":[{"award-number":["HHSH250201000018C"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hydroxychloroquine (HCQ) is an antimalarial drug with immunomodulatory effects used to treat systemic lupus erythematosus (SLE) and scleroderma. The antiviral effects of HCQ have raised attention in the context of the COVID\u201019 pandemic, although safety is controversial. We examined linkages of national transplant registry data with pharmaceutical claims and Medicare billing claims to study HCQ use among Medicare\u2010insured kidney transplant recipients with SLE or scleroderma (2008\u20132017; N\u00a0=\u00a01820). We compared three groups based on immunosuppression regimen 7 months\u2010to\u20101 year post transplant: (a) tacrolimus (Tac)\u00a0+\u00a0mycophenolic acid (MPA)\u00a0+\u00a0prednisone (Pred) (referent group, 77.7%); (b) Tac\u00a0+\u00a0MPA\u00a0+\u00a0Pred\u00a0+\u00a0HCQ (16.5%); or (c) other immunosuppression\u00a0+\u00a0HCQ (5.7%). Compared to the referent group, recipients treated with other immunosuppression\u00a0+\u00a0HCQ had a 2\u2010fold increased risk of abnormal ECG or QT prolongation (18.9% vs. 10.7%; aHR,<jats:sub>1.12<\/jats:sub>1.96<jats:sub>3.42<\/jats:sub>, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02) and ventricular arrhythmias (15.2% vs. 11.4%; aHR,<jats:sub>1.00<\/jats:sub>1.81<jats:sub>3.29<\/jats:sub>, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.05) in the &gt;1\u2010to\u20103\u00a0years post\u2010transplant. Tac\u00a0+\u00a0MPA\u00a0+\u00a0Pred\u00a0+\u00a0HCQ was associated with increased risk of ventricular arrhythmias (13.5% vs. 11.4%; aHR,<jats:sub>1.02<\/jats:sub>1.54<jats:sub>2.31<\/jats:sub>, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04) and pancytopenia (35.9% vs. 31.4%; aHR,<jats:sub>1.03<\/jats:sub>1.31<jats:sub>1.68<\/jats:sub>, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03) compared to triple immunosuppression without HCQ. However, HCQ\u2010containing regimens were not associated with an increased risk of death or graft failure. HCQ may be used safely in selected kidney transplant recipients in addition to their maintenance immunosuppression, although attention to arrhythmias is warranted.<\/jats:p>","DOI":"10.1111\/ctr.14118","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T19:14:47Z","timestamp":1602616487000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Hydroxychloroquine and maintenance immunosuppression use in kidney transplant recipients: Analysis of linked US registry and claims data"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-4849","authenticated-orcid":false,"given":"Krista L.","family":"Lentine","sequence":"first","affiliation":[{"name":"Center for Abdominal Transplantation Saint Louis University St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0129-7091","authenticated-orcid":false,"given":"Ngan N.","family":"Lam","sequence":"additional","affiliation":[{"name":"University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasar","family":"Caliskan","sequence":"additional","affiliation":[{"name":"Center for Abdominal Transplantation Saint Louis University St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek","family":"Alhamad","sequence":"additional","affiliation":[{"name":"Washington University in Saint Louis St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiling","family":"Xiao","sequence":"additional","affiliation":[{"name":"Center for Abdominal Transplantation Saint Louis University St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Center for Abdominal Transplantation Saint Louis University St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su\u2010Hsin","family":"Chang","sequence":"additional","affiliation":[{"name":"Washington University in Saint Louis St. Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5684-0613","authenticated-orcid":false,"given":"David","family":"Axelrod","sequence":"additional","affiliation":[{"name":"University of Iowa Iowa City IA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-925X","authenticated-orcid":false,"given":"Mara","family":"McAdams\u2010DeMarco","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertram L.","family":"Kasiske","sequence":"additional","affiliation":[{"name":"Hennepin County Med Center Minneapolis MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory P.","family":"Hess","sequence":"additional","affiliation":[{"name":"Drexel University Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel C.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203306071872"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.068676"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199101173240303"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1191\/096120398678919778"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21039"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40560"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2016.10.002"},{"issue":"8","key":"e_1_2_9_9_1","first-page":"4539","article-title":"Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID\u201019","volume":"24","author":"Meo SA","year":"2020","journal-title":"Eur Rev Med Pharmacol 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