Note that MI was a secondary outcome in the study by Haugaard et al. 39 HCQ has a known lipid-lowering effect40 and ameliorate inflammation in SLE41 partly through decreased interleukin (IL)-1β and IL-6 production.42 These cytokines have been attributed a casual role in the process of atherosclerosis.43 44 Taken together, the result from the present study is in line with larger prospective and mechanistic studies, which suggest an atheroprotective effect from HCQ use in patients with SLE. This evidence concerns the gene IL1B and systemic lupus erythematosus.