Benefits of Using Hydroxychloroquine/Chloroquine in the Treatment of Immunomediated Rheumatic Diseases

Abstract

Antimalarial drugs, particularly hydroxychloroquine (HCQ) and chloroquine (CQ), have been used for decades as cornerstone therapies in the management of immune‑mediated rheumatic diseases (IMRDs). Beyond their classical role in disease activity control, these agents exert pleiotropic effects encompassing immunomodulation, anti‑inflammatory signaling, antithrombotic activity, and metabolic and cardiovascular protection. Robust clinical evidence supports their ability to reduce disease flares, limit cumulative organ damage, improve long‑term survival, and decrease infection risk, especially in systemic lupus erythematosus (SLE). This review provides an in‑depth and updated analysis of the mechanisms of action, clinical applications across autoimmune diseases, metabolic and vascular effects, safety profile, and emerging therapeutic perspectives of HCQ and CQ, highlighting their enduring relevance and expanding role in contemporary rheumatology and systemic medicine.