Hydroxychloroquine's Role in Fever Prevention in Sjögren's Syndrome

Mechanism of Action and Effects on Fever

Hydroxychloroquine (HCQ) is commonly used in autoimmune conditions such as Sjögren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis for its immunomodulatory effects, which may indirectly affect inflammatory processes by inhibiting tumor necrosis factor-alpha and interleukin-6 (IL-6) 1, 2
The American College of Rheumatology recommends HCQ for its immunomodulatory properties in autoimmune conditions, although there is no evidence supporting its role as a long-term fever preventative agent 1

Long-term HCQ use requires monitoring for potential side effects, particularly retinal toxicity, with baseline ophthalmic examination and follow-up every 6 months, as recommended by medical guidelines 1

The absence of fever for twenty years is unlikely to be solely attributed to HCQ use and may be related to other factors, such as individual variation in immune response, potential subclinical infections, or other medications the patient might be taking concurrently, according to the Centers for Disease Control and Prevention 3
Possible alterations in thermoregulatory mechanisms unrelated to medication may also contribute to the absence of fever, as suggested by research in Military Medical Research 2

The Centers for Disease Control and Prevention recommends HCQ in combination with doxycycline for treating chronic infections like Q fever, not specifically for fever management 3, 1
There is insufficient evidence to recommend HCQ solely as an antipyretic agent in the absence of specific indications like autoimmune conditions, as stated by the American College of Rheumatology 1