{
  "abstract": "Background and objectives\n\nPatients with systemic lupus erythematosus (SLE) are at increased risk of osteoporosis due to chronic inflammation, prolonged glucocorticoid (GC) exposure, and treatment-related factors. Hydroxychloroquine (HCQ), a cornerstone of SLE therapy, has shown conflicting effects on bone health. This study examined the association between HCQ use and bone mineral density (BMD) in SLE.Methods\n\nA cross-sectional study of 213 SLE patients was conducted at Dr. Soetomo General Academic Hospital. BMD was assessed by dual-energy X-ray absorptiometry (DXA) and classified using WHO criteria. Demographic, clinical, laboratory, and treatment-related variables were collected. Group comparisons employed chi-square and non-parametric tests, while ordinal logistic regression identified independent predictors of reduced BMD.Results\n\nAmong 213 patients, 22.5% had normal BMD, 51.2% osteopenia, and 26.3% osteoporosis. Independent predictors of reduced BMD were older age (OR 1.05, 95% CI 1.01-1.09), higher cumulative GC exposure (OR 1.07, 95% CI 1.02-1.12), and lower BMI (OR 0.89, 95% CI 0.80-0.98). Importantly, the use of HCQ has been linked to a protective effect against osteoporosis (OR 0.47, 95% CI 0.22-0.97, P = 0.040). Neither SLEDAI scores nor complement/ESR levels were significantly associated with BMD.Conclusion\n\nLow BMD is highly prevalent in SLE and is strongly influenced by age, GC exposure, and BMI. HCQ use was linked to a protective effect on bone health, plausibly mediated by anti-resorptive, antioxidant, and glucocorticoid-sparing properties. Although a causal relationship between these two variables cannot yet be established, this association underscores the need for further well-designed longitudinal or interventional studies.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Rheumatology, Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.",
    "Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.",
    "Department of Internal Medicine, Faculty of Medicine - Widya Mandala Catholic University, Surabaya, Indonesia.",
    "Department of Radiology, Faculty of Medicine - Universitas Airlangga, Surabaya, Indonesia.",
    "Department of Rheumatology, St Vincent's Hospital, Fitzroy, Australia."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Awalia",
      "orcid": "0000-0002-4232-384X"
    },
    {
      "affs": [
        2
      ],
      "name": "Stefanus Gunawan Kandinata"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Arinditia Triasti Putri"
    },
    {
      "affs": [
        0
      ],
      "name": "Abellia"
    },
    {
      "affs": [
        0
      ],
      "name": "Lilik Maulidyatus Sholikhah"
    },
    {
      "affs": [
        3
      ],
      "name": "Rosy Setiawati"
    },
    {
      "affs": [
        4
      ],
      "name": "Mandana Nikpour"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d39mzxfh87d7d.bib",
  "cited_by": 0,
  "doi": "10.1515/rir-2026-0017",
  "fulltext_url": "https://europepmc.org/articles/PMC13689947",
  "id": "d39mzxfh87d7d",
  "issns": [
    "2719-4523"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923751",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Bone health and osteoporosis research"
    ]
  ],
  "openalex": "W7172221912",
  "pdf_url": "https://europepmc.org/articles/PMC13689947?pdf=render",
  "pmcid": "PMC13689947",
  "pmid": "42923751",
  "published": "2026-08-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d39mzxfh87d7d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42923751",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923751"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Bone health and osteoporosis research",
      "subfield": "surgery"
    }
  ],
  "title": "Hydroxychloroquine therapy and its impact on bone mineral density among systemic lupus erythematosus patients: A cross-sectional study.",
  "title_text": "Hydroxychloroquine therapy and its impact on bone mineral density among systemic lupus erythematosus patients: A cross-sectional study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/d39mzxfh87d7d",
  "venue": "Rheumatology and immunology research",
  "versions": []
}