ReviewNature reviews. Rheumatology2020
Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology.
Review in Nature reviews. Rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 758 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Double-Blind Placebo-Controlled Trial on the Safety and Efficacy of Imatinib for Hospitalized Adults With COVID-19
Efficacy and Safety of Hydroxychloroquine in Patients With X-linked Alport Syndrome in China (CHXLAS)
Using Hydroxychloroquine to Treat Nonalcoholic Steatohepatitis
TALLman Family Energizes Research To Help Alleviate Neuroinflammation in Parkinson's Disease - "TALLER THAN PD." A Phase 2 Futility Study to Evaluate the Efficacy, Safety and Tolerability of Hydroxychloroquine in Subjects With Early Treated Parkinson's Disease
A Single Center, Open Label Phase II Clinical Trial of Hydroxychloroquine Sulfate Tablets for the Treatment of Radiation Stomatitis and Taste Disturbance in Intensity Modulated Radiotherapy for Head and Neck Cancer
Who cites it
758 citing papers in PubMed, 3 syntheses or guidelines pooled it, 1,455 citations in OpenAlex.
- Hydroxychloroquine and pregnancy outcomes in patients with anti-phospholipid syndrome: a systematic review and meta-analysis.RMD open · 2025Pooled it
- Hydroxychloroquine-Chloroquine, QT-Prolongation, and Major Adverse Cardiac Events: A Meta-analysis and Scoping Review.The Annals of pharmacotherapy · 2024Pooled it
- Hydroxychloroquine and COVID-19 story: is the low-dose treatment the missing link? A comprehensive review and meta-analysis.Naunyn-Schmiedeberg's archives of pharmacology · 2024Pooled it
- The efficacy and safety of hydroxychloroquine in patients with chronic inflammatory cardiomyopathy: a multicenter randomized study (HYPIC trial).BMC medicine · 2025Trial
- An open-label phase I comparator-controlled clinical trial to assess tolerability and pharmacokinetics of IHL-675 A a fixed dose combination of cannabidiol plus hydroxychloroquine in healthy volunteers.Scientific reports · 2025Trial
- Trial
- A single-center, open label, randomized, controlled study of hydroxychloroquine sulfate in the treatment of low risk PLABMC nephrology · 2024Trial
- Overexpression of Synoviolin and miR-125a-5p, miR-19b-3p in peripheral blood of rheumatoid arthritis patients after treatment with conventional DMARDs and methylprednisolone.Clinical rheumatology · 2024Trial
- Progress on quinoline‑based antitumour agents: Mechanistic insights and optimization strategies (Review).Molecular medicine reports · 2026Review
- Risk factors for infection in rheumatoid arthritis patients treated with tocilizumab: an observational study highlighting hydroxychloroquine use.Clinical rheumatology · 2026Observational
- Lysosomal metabolism in pancreatic cancer and its crosstalk with host physiology.Genes & development · 2026Review
- Chloroquine and hydroxychloroquine retinopathy in a cohort with rheumatic diseases in Mexico: prevalence, risk factors, and retinopathy patterns.Clinical rheumatology · 2026Article
- Review
- Hepatic control of immunometabolism: implications for the pathogenesis, diagnosis and treatment of rheumatic diseases.Nature reviews. Rheumatology · 2026Review
- A Nutrient-Sensitive ZRF1-Dependent Secretory Network Involving S100A9 Contributes to Neutrophil Plasticity in Triple-Negative Breast Cancer.ACS pharmacology & translational science · 2026Article
- Autophagy functions in lung macrophages and dendritic cells to regulate allergen-dependent inflammatory responses.Autophagy · 2026Article
- Frequency and clinical characteristics of hydroxychloroquine-induced pigmentation in Japanese paediatric patients: a retrospective cohort study.Rheumatology international · 2026Article
- Hydroxychloroquine-Induced AGEP with Positive Rechallenge: A Case Report and Mini Review of the Literature.Dermatopathology (Basel, Switzerland) · 2026Article
- Viral capsid delivery of cGAMP enhances STING-dependent antitumor immune response.bioRxiv : the preprint server for biology · 2026Article
- Facilitators and barriers to medication adherence in systemic lupus erythematosus: a qualitative study in China.Scientific reports · 2026Article
698 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite widespread clinical use of antimalarial drugs such as hydroxychloroquine and chloroquine in the treatment of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and other inflammatory rheumatic diseases, insights into the mechanism of action of these drugs are still emerging. Hydroxychloroquine and chloroquine are weak bases and have a characteristic 'deep' volume of distribution and a half-life of around 50 days. These drugs interfere with lysosomal activity and autophagy, interact with membrane stability and alter signalling pathways and transcriptional activity, which can result in inhibition of cytokine production and modulation of certain co-stimulatory molecules. These modes of action, together with the drug's chemical properties, might explain the clinical efficacy and well-known adverse effects (such as retinopathy) of these drugs. The unknown dose-response relationships of these drugs and the lack of definitions of the minimum dose needed for clinical efficacy and what doses are toxic pose challenges to clinical practice. Further challenges include patient non-adherence and possible context-dependent variations in blood drug levels. Available mechanistic data give insights into the immunomodulatory potency of hydroxychloroquine and provide the rationale to search for more potent and/or selective inhibitors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.