Table 2 Qualitative data for the six studies selected for CQ/HCQ-induced myopathy.

From: The toxic effects of chloroquine and hydroxychloroquine on skeletal muscle: a systematic review and meta-analysis

Authors

Year

Patients treated with HCQ/CQ

Number of patients with clinical symptoms

of muscle toxicity

Number of patients with biopsy for drug induced myopathy

Number of patients with elevated muscle enzymes (CK or LHD)

Intervention after diagnosis of muscle toxicity

Outcome after drug discontinuation

Wang et al.32

1999

156 HCQ or CQ

2

1

0

Drug discontinuation

Both patients clinically improved after discontinuation (2 months)

Casado et al.9

2005

111 CQ/8HCQ

15

15

22

Drug discontinuation in 7 patients

Signs and symptoms disappeared for 5 of 7 patient, one NR and 1 diminished

Kalajian et al.33

2009

8 CQ/13 HCQ

7

NR

4

Suggest discontinuation, but NR

NR

Tselios et al.23

2016

184CQ/853 HCQ

5

0

216

203 patients were followed for 7.3 ± 5.6 years: 49.8% had persistent and 14.8% intermittent CPK elevation

No drug discontinuation reported

Khoo et al.5

2017

34 HCQ

18 (10*)

18

10

N/A

N/A

  1. In Casado et al.9, 22 patients were reported with elevated muscle enzymes, but only 15 patients are present with complete follow-up information for clinical symptoms. Regarding the study of Tselios et al.23, the number of patients treated with HCQ or CQ were extracted from a total of 1,037 patients. Symbol (*) indicate patients presenting muscle weakness and without histological features/markers positive for active inflammatory myositis (primary disease).
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