Talk:Hydroxychloroquine

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A note on WP:MEDRS: Per this Wikipedia policy, we must rely on the highest quality secondary sources and the recommendations of professional organizations and government bodies when determining the scientific consensus about medical treatments.

Ivermectin: The highest quality sources (1 2 3 4) suggest Ivermectin is not an effective treatment for COVID-19. In all likelihood, ivermectin does not reduce all-cause mortality (moderate certainty) or improve quality of life (high certainty) when used to treat COVID-19 in the outpatient setting (4). Recommendations from relevant organizations can be summarized as: Evidence of efficacy for ivermectin is inconclusive. It should not be used outside of clinical trials. (May 2021, June 2021, June 2021, July 2021, July 2021) (WHO, FDA, IDSA, ASHP, CDC, NIH)
Chloroquine & hydroxychloroquine: The highest quality sources (1 2 3 4) demonstrate that neither is effective for treating COVID-19. These analyses accounted for use both alone and in combination with azithromycin. Some data suggest their usage may worsen outcomes. Recommendations from relevant organizations can be summarized: Neither hydroxychloroquine nor chloroquine should be used, either alone or in combination with azithromycin, in inpatient or outpatient settings. (July 2020, Aug 2020, Sep 2020, May 2021) (WHO, FDA, IDSA, ASHP, NIH)
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Last updated (diff) on 13 May 2025 by GreenC (t · c)

Extended-confirmed-protected edit request on 7 July 2026 (Sjögren syndrome)

Latest comment: 1 month ago1 comment1 person in discussion

It is requested that an edit be made to the extended-confirmed-protected article at Hydroxychloroquine. (edit · history · last · links · protection log)

This template must be followed by a complete and specific description of the request, that is, specify what text should be removed and a verbatim copy of the text that should replace it. "Please change X" is not acceptable and will be rejected; the request must be of the form "please change X to Y".

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I would like to add context to the efficacy in Sjögren syndrome treatment, by replacing the first sentence in section Medical uses with the following new subsection. The current one makes a definite statement while the situation is not that clear.

Sjögren's disease

Hydroxychloroquine is the most frequently prescribed systemic drug for primary Sjögren's disease,^[1] and EULAR guidelines suggest it may be considered for frequent joint pain episodes, while not recommending it for dry eyes and dry mouth.^[2] Its efficacy as monotherapy is disputed. The JOQUER randomized trial (2014) found no improvement over placebo in dryness, pain, or fatigue at 24 weeks,^[1] despite reducing ESR, immunoglobulins, and the type I interferon signature.^[3]

Later reanalysis stratifying patients into symptom-based subgroups found improvement in the patient-reported symptom score (ESSPRI) among patients with high symptom burden.^[4] A 2021 meta-analysis reported benefit for oral symptoms and inflammatory markers,^[5] and a large observational study in 2025 found greater response in patients positive for anti-SSA/Ro autoantibodies and/or rheumatoid factor.^[6]

Separately, two randomized trials in 2020 and 2026 found that hydroxychloroquine combined with leflunomide significantly reduced systemic disease activity (ESSDAI score) versus placebo.^[7]^[8]

Przemub (talk) 13:41, 7 July 2026 (UTC)Reply

Protected edit request August 6th 2026

Latest comment: 4 days ago1 comment1 person in discussion

Currently, the article states, "Methotrexate (combined use is unstudied and may increase the frequency of side effects)"... However, an edit should be made noting that this is not the case for rheumatoid arthritis, where combination therapy is common. ~2026-43288-51 (talk) 05:45, 7 August 2026 (UTC)Reply

1 2 Gottenberg, JE; et al. (2014). "Effects of hydroxychloroquine on symptomatic improvement in primary Sjögren syndrome: the JOQUER randomized clinical trial". JAMA. 312 (3): 249–258. doi:10.1001/jama.2014.7682. PMID 25027140.
↑ Ramos-Casals, M; et al. (2020). "EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies". Annals of the Rheumatic Diseases. 79 (1): 3–18. doi:10.1136/annrheumdis-2019-216114. PMID 31672775.
↑ Bodewes, ILA; et al. (2020). "Hydroxychloroquine treatment downregulates systemic interferon activation in primary Sjögren's syndrome in the JOQUER randomized trial". Rheumatology (Oxford). 59 (1): 107–111. doi:10.1093/rheumatology/kez242. PMID 31237947.
↑ Collins, A; et al. (2021). "Revisiting the JOQUER trial: stratification of primary Sjögren's syndrome and the clinical and interferon response to hydroxychloroquine". Rheumatology International. 41 (9): 1593–1600. doi:10.1007/s00296-021-04927-y.
↑ Wang X, Zhang T, Guo Z, Pu J, Riaz F, Feng R, Fang X, Song J, Liang Y, Wu Z, Pan S, Tang J (2021). "The efficiency of hydroxychloroquine for the treatment of primary Sjögren's syndrome: a systematic review and meta-analysis". Frontiers in Pharmacology. 12 693796. doi:10.3389/fphar.2021.693796. PMC 8475756.
↑ Zhu, K; et al. (2025). "Treatment effectiveness of hydroxychloroquine in patients with primary Sjögren's syndrome: a real-world study". Clinical Rheumatology. doi:10.1007/s10067-025-07583-w. PMID 40751894.
↑ van der Heijden, EHM; et al. (2020). "Leflunomide–hydroxychloroquine combination therapy in patients with primary Sjögren's syndrome (RepurpSS-I): a placebo-controlled, double-blinded, randomised clinical trial". The Lancet Rheumatology. 2 (5): e260–e269. doi:10.1016/S2665-9913(20)30057-6. PMID 38273473.
↑ Wong, WY; Rijnenberg, D; et al. (2026). "Repurposing leflunomide and hydroxychloroquine to treat Sjögren's disease (RepurpSS-II): a randomised, double-blind, placebo-controlled, phase 2b trial". The Lancet Rheumatology. doi:10.1016/S2665-9913(26)00075-5.

[JOQUER-1] 1 2 Gottenberg, JE; et al. (2014). "Effects of hydroxychloroquine on symptomatic improvement in primary Sjögren syndrome: the JOQUER randomized clinical trial". JAMA. 312 (3): 249–258. doi:10.1001/jama.2014.7682. PMID 25027140.

[EULAR2020-2] Ramos-Casals, M; et al. (2020). "EULAR recommendations for the management of Sjögren's syndrome with topical and systemic therapies". Annals of the Rheumatic Diseases. 79 (1): 3–18. doi:10.1136/annrheumdis-2019-216114. PMID 31672775.

[Bodewes2020-3] Bodewes, ILA; et al. (2020). "Hydroxychloroquine treatment downregulates systemic interferon activation in primary Sjögren's syndrome in the JOQUER randomized trial". Rheumatology (Oxford). 59 (1): 107–111. doi:10.1093/rheumatology/kez242. PMID 31237947.

[Collins2021-4] Collins, A; et al. (2021). "Revisiting the JOQUER trial: stratification of primary Sjögren's syndrome and the clinical and interferon response to hydroxychloroquine". Rheumatology International. 41 (9): 1593–1600. doi:10.1007/s00296-021-04927-y.

[Wang2021-5] Wang X, Zhang T, Guo Z, Pu J, Riaz F, Feng R, Fang X, Song J, Liang Y, Wu Z, Pan S, Tang J (2021). "The efficiency of hydroxychloroquine for the treatment of primary Sjögren's syndrome: a systematic review and meta-analysis". Frontiers in Pharmacology. 12 693796. doi:10.3389/fphar.2021.693796. PMC 8475756.

[Zhu2025-6] Zhu, K; et al. (2025). "Treatment effectiveness of hydroxychloroquine in patients with primary Sjögren's syndrome: a real-world study". Clinical Rheumatology. doi:10.1007/s10067-025-07583-w. PMID 40751894.

[RepurpSS1-7] van der Heijden, EHM; et al. (2020). "Leflunomide–hydroxychloroquine combination therapy in patients with primary Sjögren's syndrome (RepurpSS-I): a placebo-controlled, double-blinded, randomised clinical trial". The Lancet Rheumatology. 2 (5): e260–e269. doi:10.1016/S2665-9913(20)30057-6. PMID 38273473.

[RepurpSS2-8] Wong, WY; Rijnenberg, D; et al. (2026). "Repurposing leflunomide and hydroxychloroquine to treat Sjögren's disease (RepurpSS-II): a randomised, double-blind, placebo-controlled, phase 2b trial". The Lancet Rheumatology. doi:10.1016/S2665-9913(26)00075-5.

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