{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:13:10Z","timestamp":1782299590729,"version":"3.54.5"},"reference-count":28,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"unspecified","delay-in-days":174,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015866","name":"Hezkuntza, Hizkuntza Politika Eta Kultura Saila, Eusko Jaurlaritza","doi-asserted-by":"publisher","award":["IT 1512-22"],"award-info":[{"award-number":["IT 1512-22"]}],"id":[{"id":"10.13039\/100015866","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy of mepacrine (MC) as an add-on therapy in patients with SLE unresponsive to hydroxychloroquine (HCQ)-containing regimens at 6 months after MC introduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational study using routine clinical care data of patients from the Lupus-Cruces cohort. All of them received therapy with HCQ and prednisone at baseline. Two groups of initial therapy were compared: single therapy (ST; HCQ + prednisone) and multiple therapy (MT; additional immunosuppressives or biologics). Achieving the definition of remission in SLE (DORIS) at 6 months was the main outcome. Prednisone tapering and MC side effects and discontinuation were also analysed. A logistic regression was performed in search of clinical predictors of response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>106 different episodes were included (ST=56, MT=50). The mean SLE Disease Activity Index (SLEDAI) at baseline was 6.7, with a mean prednisone dose of 6\u2009mg\/day. DORIS remission at 6 months was 71% for the complete cohort (ST 79% vs MT 62%, p=0.06). SLEDAI reduction at 6 months was similar in both groups (mean 4.6 points in the ST group vs 5 in the MT group, p=0.5). The reduction at 6 months was also similar (mean 1.75\u2009mg\/day in the ST group vs 1.69\u2009mg\/day in the MT group, p=0.9). The most frequent reason for MC discontinuation was improvement (45%). Adverse effects were reported in 17% patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MC is a useful therapy in mild\u2013moderate active SLE. Using MC as the first drug after the failure of glucocorticoids and HCQ is the best option; however, the addition of MC to a multidrug regimen can also be of help.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001772","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:00:17Z","timestamp":1766487617000},"page":"e001772","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Combining mepacrine with hydroxychloroquine-based therapy in active systemic lupus erythematosus: an observational study of 106 patients from the Lupus-Cruces cohort"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1007-5378","authenticated-orcid":false,"given":"Beatriz","family":"Mar\u00edn-Garc\u00eda","sequence":"first","affiliation":[{"name":"Autoimmune Diseases Research Unit, Biobizkaia Health Research Institute, Barakaldo, 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