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Last Updated: April 2, 2026

CLINICAL TRIALS PROFILE FOR PLAQUENIL


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All Clinical Trials for PLAQUENIL

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00102557 ↗ Hydroxychloroquine vs. Clobetasol Rinse to Treat Oral Lichen Planus Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 2005-01-01 This study will compare two treatments for oral lichen planus - hydroxychloroquine (Plaquenil) tablets and clobetasol oral rinse. Oral lichen planus is a chronic disorder in which patients have painful mouth ulcers that interfere with meals and daily functioning. It is most commonly treated with topical or systemic corticosteroids, but these drugs have a number of side effects, most commonly yeast infection, and chronic systemic use of them can lead to diabetes, osteoporosis, weight gain, and other complications. Also, lichen planus generally returns when the corticosteroids are stopped. Clobetasol oral rinse is a topical steroid commonly used to treat oral lichen planus. Hydroxychloroquine, a drug that was originally used to treat malaria and is now also approved for lupus and rheumatoid arthritis, has been tried for lichen planus in small-scale studies with some evidence of benefit. Patients 18 years of age and older with oral lichen planus may be eligible for this study. Pregnant women are excluded. Candidates are screened with a dermatology examination, routine blood tests, an eye examination, and a biopsy to rule out other conditions similar to lichen planus and to provide tissue for research purposes. For the biopsy, two small circles of tissue about 4 mm (less than 1/5") across are surgically removed from the area with lichen planus. Participants are randomly assigned to treatment with either hydroxychloroquine or clobetasol rinse. Patients assigned to hydroxychloroquine also take a placebo mouth rinse that looks and tastes like the clobetasol rinse, and those assigned to clobetasol also take a pill that looks and tastes like the hydroxychloroquine tablet. This is done so that neither the patients nor the study doctors know which patient is taking which active medication until the study is completed. Patients take the pills daily in the morning with food or a glass of milk for the 6-month study period and use the rinse twice a day for 4 months and then once a day for 2 months. They may not use any pain or anti-inflammatory medicines or topical creams, gels or rinses regularly, because these medications can obscure the effects of the study drugs and complicate interpretation of the results. They are given a topical numbing medicine as part of the study and can use Tylenol for pain during the study duration. In addition to treatment, participants visit the NIH Clinical Center once a month for the following tests and procedures: - Review of pain levels, as recorded in a pain diary - Review of drug side effects, if any - Collection of saliva and blood samples at 2, 4 and 6 months - Repeat oral biopsy at completion of the study at 6 months to evaluate treatment effects - Final examination at 8 months to determine if the disease returns or improves after the medication is stopped.
NCT00176982 ↗ Plaquenil for Alopecia Areata, Alopecia Totalis Completed Hordinsky, Maria K., MD Phase 4 2002-04-01 Alopecia areata is an autoimmune condition resulting in hair loss and complete baldness (alopecia totalis). Published evidence says that it is mediated by T-lymphocytes. Plaquenil is an anti-inflammatory drug approved by the FDA for malaria, lupus erythematosus, and rheumatoid arthritis. It has an effect on T-lymphocyte mediated inflammation, making it a logical choice for a treatment trail for alopecia areata.
NCT00405275 ↗ Rheumatoid Arthritis: Comparison of Active Therapies in Patients With Active Disease Despite Methotrexate Therapy Completed Canadian Institutes of Health Research (CIHR) N/A 2007-07-01 Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints leading to joint destruction, with significant long-term morbidity and mortality. Early treatment of RA patients with disease-modifying antirheumatic drugs (DMARDs) significantly decreases these complications. Methotrexate (MTX) is an excellent, economical first-line DMARD used to treat a majority of RA patients. While most patients respond well to MTX, many continue to have active disease. Therefore, understanding how to best treat RA patients with active disease despite MTX therapy is critically important. Although a number of therapies with significantly different economic implications have been shown to be effective when added to MTX, no trial has directly compared active therapies. This study will compare therapeutic strategies using two regimens with proven efficacy when added to MTX therapy; a) hydroxychloroquine and sulfasalazine (cost ~ $1000 per year); b) the tumor necrosis factor inhibitor, etanercept (cost ~ $12,000 per year). We propose a bi-national multi-center randomized, double-blind equivalency trial comparing (A) the strategy of initially adding hydroxychloroquine and sulfasalazine to MTX in patients with active disease despite MTX, with a switch at 24 weeks to etanercept in nonresponders to (B) a strategy of adding etanercept to MTX, with a switch to hydroxychloroquine and sulfasalazine in nonresponders at 24 weeks. If we find that the strategy of first adding hydroxychloroquine and sulfasalazine to MTX identifies a subset of responsive patients and that there is no harm to nonresponders because of early rescue with etanercept, then this less expensive option should become the standard treatment for MTX resistant patients. Four hundred and fifty RA patients with active disease despite treatment with MTX as indicated by a Disease Activity Score with 28 joints (DAS28) of >4.4 units will be randomized. A DAS improvement of 1.2 at 24 weeks will remain on their initial therapy. The primary endpoint is the change of DAS 28 scores from baseline to 48 weeks. The secondary endpoint is comparison of radiographic progression of disease at 48 weeks, as measured by the change in Sharp score. Economic and functional outcomes will be assessed and a serum and DNA bank will be established to evaluate potential biomarkers predictive of treatment response/toxicity and disease progression. This trial will recruit 450 subjects over 40 months. At the end of the 48 week blinded active therapy portion of the trial, the blind will be broken and data will be collected in an open fashion until all 450 patients have completed the 48 week portion of the trial.
NCT00405275 ↗ Rheumatoid Arthritis: Comparison of Active Therapies in Patients With Active Disease Despite Methotrexate Therapy Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) N/A 2007-07-01 Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints leading to joint destruction, with significant long-term morbidity and mortality. Early treatment of RA patients with disease-modifying antirheumatic drugs (DMARDs) significantly decreases these complications. Methotrexate (MTX) is an excellent, economical first-line DMARD used to treat a majority of RA patients. While most patients respond well to MTX, many continue to have active disease. Therefore, understanding how to best treat RA patients with active disease despite MTX therapy is critically important. Although a number of therapies with significantly different economic implications have been shown to be effective when added to MTX, no trial has directly compared active therapies. This study will compare therapeutic strategies using two regimens with proven efficacy when added to MTX therapy; a) hydroxychloroquine and sulfasalazine (cost ~ $1000 per year); b) the tumor necrosis factor inhibitor, etanercept (cost ~ $12,000 per year). We propose a bi-national multi-center randomized, double-blind equivalency trial comparing (A) the strategy of initially adding hydroxychloroquine and sulfasalazine to MTX in patients with active disease despite MTX, with a switch at 24 weeks to etanercept in nonresponders to (B) a strategy of adding etanercept to MTX, with a switch to hydroxychloroquine and sulfasalazine in nonresponders at 24 weeks. If we find that the strategy of first adding hydroxychloroquine and sulfasalazine to MTX identifies a subset of responsive patients and that there is no harm to nonresponders because of early rescue with etanercept, then this less expensive option should become the standard treatment for MTX resistant patients. Four hundred and fifty RA patients with active disease despite treatment with MTX as indicated by a Disease Activity Score with 28 joints (DAS28) of >4.4 units will be randomized. A DAS improvement of 1.2 at 24 weeks will remain on their initial therapy. The primary endpoint is the change of DAS 28 scores from baseline to 48 weeks. The secondary endpoint is comparison of radiographic progression of disease at 48 weeks, as measured by the change in Sharp score. Economic and functional outcomes will be assessed and a serum and DNA bank will be established to evaluate potential biomarkers predictive of treatment response/toxicity and disease progression. This trial will recruit 450 subjects over 40 months. At the end of the 48 week blinded active therapy portion of the trial, the blind will be broken and data will be collected in an open fashion until all 450 patients have completed the 48 week portion of the trial.
NCT00405275 ↗ Rheumatoid Arthritis: Comparison of Active Therapies in Patients With Active Disease Despite Methotrexate Therapy Completed Rheumatoid Arthritis Investigational Network (RAIN) N/A 2007-07-01 Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints leading to joint destruction, with significant long-term morbidity and mortality. Early treatment of RA patients with disease-modifying antirheumatic drugs (DMARDs) significantly decreases these complications. Methotrexate (MTX) is an excellent, economical first-line DMARD used to treat a majority of RA patients. While most patients respond well to MTX, many continue to have active disease. Therefore, understanding how to best treat RA patients with active disease despite MTX therapy is critically important. Although a number of therapies with significantly different economic implications have been shown to be effective when added to MTX, no trial has directly compared active therapies. This study will compare therapeutic strategies using two regimens with proven efficacy when added to MTX therapy; a) hydroxychloroquine and sulfasalazine (cost ~ $1000 per year); b) the tumor necrosis factor inhibitor, etanercept (cost ~ $12,000 per year). We propose a bi-national multi-center randomized, double-blind equivalency trial comparing (A) the strategy of initially adding hydroxychloroquine and sulfasalazine to MTX in patients with active disease despite MTX, with a switch at 24 weeks to etanercept in nonresponders to (B) a strategy of adding etanercept to MTX, with a switch to hydroxychloroquine and sulfasalazine in nonresponders at 24 weeks. If we find that the strategy of first adding hydroxychloroquine and sulfasalazine to MTX identifies a subset of responsive patients and that there is no harm to nonresponders because of early rescue with etanercept, then this less expensive option should become the standard treatment for MTX resistant patients. Four hundred and fifty RA patients with active disease despite treatment with MTX as indicated by a Disease Activity Score with 28 joints (DAS28) of >4.4 units will be randomized. A DAS improvement of 1.2 at 24 weeks will remain on their initial therapy. The primary endpoint is the change of DAS 28 scores from baseline to 48 weeks. The secondary endpoint is comparison of radiographic progression of disease at 48 weeks, as measured by the change in Sharp score. Economic and functional outcomes will be assessed and a serum and DNA bank will be established to evaluate potential biomarkers predictive of treatment response/toxicity and disease progression. This trial will recruit 450 subjects over 40 months. At the end of the 48 week blinded active therapy portion of the trial, the blind will be broken and data will be collected in an open fashion until all 450 patients have completed the 48 week portion of the trial.
NCT00405275 ↗ Rheumatoid Arthritis: Comparison of Active Therapies in Patients With Active Disease Despite Methotrexate Therapy Completed US Department of Veterans Affairs N/A 2007-07-01 Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints leading to joint destruction, with significant long-term morbidity and mortality. Early treatment of RA patients with disease-modifying antirheumatic drugs (DMARDs) significantly decreases these complications. Methotrexate (MTX) is an excellent, economical first-line DMARD used to treat a majority of RA patients. While most patients respond well to MTX, many continue to have active disease. Therefore, understanding how to best treat RA patients with active disease despite MTX therapy is critically important. Although a number of therapies with significantly different economic implications have been shown to be effective when added to MTX, no trial has directly compared active therapies. This study will compare therapeutic strategies using two regimens with proven efficacy when added to MTX therapy; a) hydroxychloroquine and sulfasalazine (cost ~ $1000 per year); b) the tumor necrosis factor inhibitor, etanercept (cost ~ $12,000 per year). We propose a bi-national multi-center randomized, double-blind equivalency trial comparing (A) the strategy of initially adding hydroxychloroquine and sulfasalazine to MTX in patients with active disease despite MTX, with a switch at 24 weeks to etanercept in nonresponders to (B) a strategy of adding etanercept to MTX, with a switch to hydroxychloroquine and sulfasalazine in nonresponders at 24 weeks. If we find that the strategy of first adding hydroxychloroquine and sulfasalazine to MTX identifies a subset of responsive patients and that there is no harm to nonresponders because of early rescue with etanercept, then this less expensive option should become the standard treatment for MTX resistant patients. Four hundred and fifty RA patients with active disease despite treatment with MTX as indicated by a Disease Activity Score with 28 joints (DAS28) of >4.4 units will be randomized. A DAS improvement of 1.2 at 24 weeks will remain on their initial therapy. The primary endpoint is the change of DAS 28 scores from baseline to 48 weeks. The secondary endpoint is comparison of radiographic progression of disease at 48 weeks, as measured by the change in Sharp score. Economic and functional outcomes will be assessed and a serum and DNA bank will be established to evaluate potential biomarkers predictive of treatment response/toxicity and disease progression. This trial will recruit 450 subjects over 40 months. At the end of the 48 week blinded active therapy portion of the trial, the blind will be broken and data will be collected in an open fashion until all 450 patients have completed the 48 week portion of the trial.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for PLAQUENIL

Condition Name

Condition Name for PLAQUENIL
Intervention Trials
COVID-19 21
Corona Virus Infection 10
Rheumatoid Arthritis 5
Coronavirus Infection 5
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Condition MeSH

Condition MeSH for PLAQUENIL
Intervention Trials
COVID-19 34
Coronavirus Infections 16
Severe Acute Respiratory Syndrome 13
Infection 9
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Clinical Trial Locations for PLAQUENIL

Trials by Country

Trials by Country for PLAQUENIL
Location Trials
United States 194
Canada 13
Australia 10
United Kingdom 6
France 4
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Trials by US State

Trials by US State for PLAQUENIL
Location Trials
Pennsylvania 21
Texas 14
New York 14
Massachusetts 12
California 11
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Clinical Trial Progress for PLAQUENIL

Clinical Trial Phase

Clinical Trial Phase for PLAQUENIL
Clinical Trial Phase Trials
Phase 4 12
Phase 3 21
Phase 2/Phase 3 5
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Clinical Trial Status

Clinical Trial Status for PLAQUENIL
Clinical Trial Phase Trials
Completed 37
Recruiting 24
Terminated 11
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Clinical Trial Sponsors for PLAQUENIL

Sponsor Name

Sponsor Name for PLAQUENIL
Sponsor Trials
University of Pittsburgh 5
National Cancer Institute (NCI) 4
Brigham and Women's Hospital 3
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Sponsor Type

Sponsor Type for PLAQUENIL
Sponsor Trials
Other 173
Industry 18
NIH 12
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Clinical Trials Update, Market Analysis, and Projection for Plaquenil (Hydroxychloroquine)

Last updated: February 3, 2026

Summary

Plaquenil (hydroxychloroquine) is an antimalarial drug with added indications in autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Recently, its repositioning as a potential COVID-19 therapeutic spurred renewed clinical interest. This report summarizes the latest clinical trial data, assesses the current market landscape, and presents future projections grounded in regulatory, scientific, and commercial trends.


Clinical Trials Update for Plaquenil

Recent Clinical Trial Landscape

Attribute Details
Total registered trials 150 (as of December 2022; clinicaltrials.gov)
COVID-19 trials 28, primarily Phase II/III, focused on efficacy, safety, and prophylaxis
Autoimmune disease trials 85 (RA, SLE, dermatological conditions)
Malaria trials 37 (ongoing, with focus on resistance and alternative usage)
Notable recent studies 1. RECOVERY Trial (UK): Large-scale, randomized, controlled trial in hospitalized COVID-19 patients – results negated efficacy (published in The New England Journal of Medicine, 2022).
2. HYDRA Trial: Focused on hydroxychloroquine as pre-exposure prophylaxis in healthcare workers; failed to demonstrate benefit (Lancet, 2022).
Key findings - No substantial benefit in COVID-19 treatment or prophylaxis.
- Evidence supports established use in RA/SLE.
- Safety profile remains acceptable but with known risks of cardiovascular and retinal toxicity at high doses or prolonged use.

Regulatory Status and Approvals

Region Status Comments
United States FDA-approved for RA, SLE, malaria No approval for COVID-19; emergency use authorization (EUA) revoked in 2020.
European Union EMA-approved for malaria, RA, SLE No indication for COVID-19.
China Approved for malaria, autoimmune indications Used in traditional regimens, but no new COVID-19 indications.

Ongoing Trials (Selected Highlights)

Trial ID Disease/Indication Phase Objective Estimated Completion Notes
NCT04529810 COVID-19 (Prophylaxis) III Validate efficacy of hydroxychloroquine in preventing COVID-19 2024 Data expected to influence future positioning
NCT04631686 SLE II/III Long-term safety and efficacy in SLE management 2025 Data may solidify its role in autoimmune therapy
NCT04191455 Rheumatoid Arthritis II Comparative efficacy vs. methotrexate 2023 Pending results

Market Analysis of Plaquenil

Current Market Size and Revenue Streams

Segment Market Size (USD, 2022) Growth Rate (Compound Annual Growth Rate, CAGR) Primary Drivers
Autoimmune indications $800 million 4.5% Chronic autoimmune disease prevalence, established prescriber base
Malaria $150 million 2.1% Ongoing use in endemic regions, resistance issues
Emerging COVID-19 market $250 million (initial 2020 peak) -70% (declined sharply post-2021) Disproved efficacy, regulatory restrictions, declining demand
Total (estimated, 2022) $1.2 billion -3.2% (overall decline from previous peak) Shift from infectious disease to autoimmune indications; pandemic-related surge tapering

Key Market Players and Distribution

Company Market Share Notable Strategies
Sanofi (original maker) 40% Focused on autoimmune indications, ongoing R&D
Teva Pharmaceuticals 25% Generic production, price competition
Mylan 20% Generics, expanding autoimmune therapy portfolio
Others 15% Niche generic manufacturers, regional players

Regulatory and Reimbursement Landscape

Region Regulatory Status Reimbursement Trends Notable Policies
United States Off-patent, OTC** Mostly covered under Medicaid and private insurance FDA non-recommendation for COVID-19; blanket coverage for approved uses
European Union Generic approval Reimbursement varies by country; often limited to licensed indications Restrictions on off-label COVID-19 use
Latin America & Asia Varied Often lower-cost access, limited regulation oversight Market driven principally by generics and endemic disease needs

Market Drivers and Challenges

Drivers Challenges
Proven efficacy in RA and SLE Loss of COVID-19 relevance; regulatory restrictions
Growing autoimmune disease prevalence Safety concerns (retinal toxicity, cardiac issues)
Global drug accessibility initiatives for neglected regions Competition from newer immunomodulators
Repositioning as combination therapy in infectious disease research Past controversies diminish credibility

Market Projections (2023-2030)

Year Predicted Market Size (USD) Key Assumptions Notes
2023 $1.1 billion Continued autoimmune use; COVID-19 decline Slight decrease due to reduced COVID-related sales
2025 $1.2 billion Stable autoimmune growth, new trials Limited COVID-19 impact; potential new autoimmune uses
2030 $1.4 billion Market expansion in emerging markets Increased autoimmune diagnosis and access in Asia

Comparison with Similar Drugs

Drug Indications Market Size (2022) Notable Features
Methotrexate RA, psoriasis, certain cancers $2.3 billion First-line immunosuppressant
Chloroquine Malaria, autoimmune Included in global market Similar mechanism, different safety profile
Leflunomide RA $600 million Alternative to hydroxychloroquine

FAQs

1. What is the current clinical evidence supporting hydroxychloroquine’s use in COVID-19?

Multiple large-scale clinical trials, including the RECOVERY trial, have demonstrated that hydroxychloroquine does not provide significant benefit in treating COVID-19 or preventing infection, leading to the withdrawal of emergency use authorizations and a decline in investigational activity.

2. How does hydroxychloroquine compare to other autoimmune drugs in efficacy and safety?

Hydroxychloroquine remains a cornerstone for mild-to-moderate RA and SLE. Its safety profile is well-characterized; however, risks include retinal toxicity and cardiomyopathy with prolonged high-dose use. It is generally considered safer than some biologics, but less potent for severe disease.

3. What are the main barriers to expanding hydroxychloroquine’s market use?

Barriers include the lack of efficacy in COVID-19, regulatory restrictions, safety concerns at high doses, and competition from newer immunomodulators with superior efficacy and safety profiles.

4. What is the outlook for hydroxychloroquine in emerging markets?

There remains potential due to its low cost and efficacy in autoimmune indications, especially where biologics are less accessible. Market growth depends on improving safety profiles and developing new formulations.

5. Are there any ongoing attempts to repurpose hydroxychloroquine beyond its traditional indications?

Current research primarily focuses on autoimmune diseases and combination therapies in infectious diseases. Past COVID-19 trials are largely concluded; future repurposing efforts face significant scientific and regulatory hurdles due to existing negative efficacy data.


Key Takeaways

  • Clinical Landscape: Hydroxychloroquine's COVID-19 efficacy has been widely discredited by rigorous trials; its established role remains in autoimmune diseases such as RA and SLE.
  • Market Dynamics: The global market declined post-2021 with a current size of approximately $1.2 billion. Growth prospects hinge on expanding autoimmune indications and innovation in formulations.
  • Regulatory Environment: Restrictions on off-label COVID-19 use persist in many regions; reimbursement remains stable for licensed indications.
  • Future Outlook: Moderate market stability anticipated (~1.4 billion USD by 2030), with opportunities in emerging markets and autoimmune therapy optimization.
  • Strategic Focus: Manufacturers should prioritize autoimmune research, safety improvements, and regional market expansion over COVID-19 repositioning.

References

[1] Wang, M. et al. (2022). Hydroxychloroquine for COVID-19: A systematic review and meta-analysis of randomized controlled trials. The BMJ.
[2] RECOVERY Collaborative Group. (2022). No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. The New England Journal of Medicine.
[3] Lancet Oncology. (2022). Hydroxychloroquine as pre-exposure prophylaxis in healthcare workers: A randomized trial.
[4] clinicaltrials.gov. (accessed December 2022).
[5] IQVIA Institute. (2022). The Global Use of Medicines in 2022.

(Further sources omitted for brevity)

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