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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.<\/strong> <\/p>\nBack to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\nKey takeaways:<\/h2>\n\nHydralazine did not increase vasculitis risk when accounting for the competing risk for death.<\/li>\n Vasculitis risk \u201cshould probably not be the main factor\u201d in considering hydralazine, the researchers wrote.<\/li>\n<\/ul>\nHydralazine does not increase the risk for vasculitis in individuals using the medication for cardiovascular disease, according to findings published in JAMA Network Open.<\/i><\/p>\n
\u201cReports of autoimmunogenic activity with hydralazine use first emerged in the 1980s with case reports of drug-induced lupus, cutaneous leukocytoclastic vasculitis and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV),\u201d Deena Fremont, MSc,<\/b> of the Ottawa Hospital Research Institute, and colleagues wrote. \u201cHydralazine-associated vasculitis may present with pulmonary-renal syndrome, rapidly progressive glomerulonephritis, and permanent kidney or lung damage.<\/p>\n
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JAMA Netw Open<\/i>. 2026:doi:10.1001\/jamanetworkopen.2026.1943.
\u201cAs such, the product monograph warns of autoimmune disease as a potential adverse event and recommends periodic routine monitoring for a complete blood cell count, antinuclear factors, and urinary abnormalities,\u201d they added. \u201cClinical trials report only one case of lupus-like syndrome in more than 700 individuals randomized to hydralazine. Despite their inherent potential biases, health administrative databases are a useful method to examine rare adverse drug events. To date, the true extent of autoimmune-related adverse events, such as AAV, with hydralazine use remains uncertain.\u201d<\/p>\n
In a population-based, retrospective cohort study, Fremont and colleagues aimed to assess the risk for vasculitis associated with hydralazine vs. angiotensin-converting enzyme inhibitors (ACE) or angiotensin receptor blockers (ARB). Eligible participants were aged 66 years or older, and had been prescribed hydralazine for outpatient use between Jan. 1, 2008, and Dec. 31, 2021. A diagnosis of vasculitis served as the primary endpoint.<\/p>\n
The overall study population included 583,136 adults from Ontario, Canada, with a mean age of 73 years (standard deviation, 7.2). The cohort was 55.2% women. A total of 40,748 participants had been prescribed hydralazine, while 542,388 patients were observed in the ACE or ARB group.<\/p>\n
According to the findings, the hydralazine group yielded 328 vasculitis events for an overall ratio of 0.8%, which the researchers noted was higher than the 2,712 events (0.5%) in the ACE or ARB group (absolute risk difference, 0.3 percentage points; HR = 1.19; 95% CI, 1.04-1.37). <\/p>\n
However, when the competing risk for death was factored into the analysis, the difference was no longer statistically significant.<\/p>\n
\u201cIn this cohort study of adults who were newly prescribed hydralazine, the use of hydralazine may be associated with a small measurable risk of vasculitis compared with ACE or ARB use; however, this finding did not appear to represent a clinically meaningful risk given the rarity of the disease,\u201d Fremont and colleagues wrote. \u201cAlthough our findings did not determine whether hydralazine caused vasculitis, concern for vasculitis should probably not be the main factor driving a clinician\u2019s decision on the appropriateness of using hydralazine for their patient.\u201d<\/p>\n
The hydralazine group yielded 328 vasculitis events, for an overall ratio of 0.8%.<\/p>\n
The ACE or ARB group yielded 2,712 vasculitis events, for an overall ratio of 0.5%.<\/p>\n
Results were not significant when accounting for the competing risk for death.<\/p>\n
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