Antimalarials in systemic lupus erythematosus: benefits beyond disease activity

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Antimalarials, particularly hydroxychloroquine, have proven beneficial effects beyond the control of disease activity among systemic lupus erythematosus patients. Indeed, recent data support the notion that prolonged treatment with hydroxychloroquine prevents damage accrual. Furthermore, this protective effect may expand to increased survival. Although toxicity remains a concern, it is rare and should not prevent practitioners from recommending hydroxychloroquine to all lupus patients, including children and pregnant women. Adequate ophthalmological monitoring and dosing should take place.