Gracia, Margareth and Suntoko, Bantar and Hellmi, Rakhma (2022) Pengaruh Hidroksiklorokuin terhadap Kadar C Reactive Protein (CRP) dan Kadar Interleukin-6 (IL-6) pada Pasien Lupus Eritematous Sistemik. Masters thesis, Universitas Diponegoro.

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Abstract

Background: IL-6 is increased in the serum of SLE patients and correlates with the severity of the disease. Production of C-Reactive Protein (CRP) from hepatocytes through IL-6 stimulation. The increase in CRP levels in the LES in SLE patients can increase by 60% in flares. Research conducted in Japan until 2015 stated that the administration of hydroxychloroquine in SLE was proven to significantly reduce disease activity through multiple molecular pathways. Hydroxychloroquine works to modulate the immune system through lysosomal activity, autophagy and signaling pathways. This study was conducted to determine the profile of CRP and IL-6 levels in lupus patients who were given hydroxychloroquine for 8 weeks in the Indonesian population.
Objectives: Analyzing IL-6 and CRP levels in SLE patients with 200 mg hydroxychloroquine for 8 weeks.
Research methods The method used in this research is a case controlled trial. The study was conducted at Dr. Kariadi General Hospital on 56 patients. This was a pure experimental study, where the selection of treatments was done randomly. Only 48 patients were found with data that could be processed. Data normality was tested using Shapiro Wilk and statistical tests using 2-tailed test.
Results: The study was conducted on 56 SLE patients at Dr. Kariadi General Hospital, with data that could be processed as many as 48 research subjects (24 subjects with treatment and 24 control subjects), consisting of 25 subjects (56.8%) with mild disease activity and 19 patients (43, 2%) moderate disease activity. IL-6 and CRP levels did not decrease significantly. The decrease in CRP levels did not occur significantly with an average of 0.15 ± 0.44 mg/dL, the median value was 0.06 mg/dL, the lowest value was -0.66 mg/dL and the highest value was 1.7 mg/dL dL, with p = 0.680 (p>0.05). The decrease in IL-6 levels was more in patients who were given hydroxychloroquine for 8 weeks than the control group with an average of 6.87 ± 22.03 ng/dL, median 4.2 ng/dL, minimum value -35 ng/dL and maximum value of 77 ng/dL. In the control group, the results showed a decrease in IL-6 with an average of -2.22 ± 15.35 ng/dL, a median value of -0.7 ng/dL, a minimum value of -34 and a maximum value of 39.5 ng/dL. The decrease in IL-6 levels was more in patients who were given hydroxychloroquine for 8 weeks than the control group with a p value of 0.036, where decreased IL-6 levels occurred in 19 patients (79.2%) more than in the study of 11 patients (45,83%). The decrease in IL-6 decreased in the treatment group with an odds ratio of 4.491, with a confidence interval between 1.26 and 16.0.
Conclusion: Administration of 200 mg of hydroxychloroquine for 8 weeks in SLE patients had significant effect on decreasing IL-6 levels, but no decreasing on CRP levels.
Keywords: lupus, interleukin, hydroxichloroquin, lupus disease activity, C-reactive protein

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