Hydroxychloroquine may effectively reduce the risk of nonalcoholic fatty liver disease in patients with rheumatoid arthritis, according to a press release from the ACR. Previous studies have indicated that about 35% and 22% of male and female patients with rheumatoid arthritis, respectively, may develop nonalcoholic fatty liver disease. In a new study—presented by Chen et al at ACR Convergence 2023—investigators used the National Health Insurance Research Database in Taiwan to examine data from 21,000 patients with rheumatoid arthritis from 2000 to 2020. After a follow-up of over 8 years, 1.86% (n = 399) of patients developed nonalcoholic fatty liver disease. However, patients who received hydroxychloroquine were less likely to develop the disease than those who didn’t receive the drug—particularly female patients younger than 50 years. They suggested that the association between hydroxychloroquine and a reduced risk of nonalcoholic fatty liver disease may be the result of the drug’s ability to increase adiponectin levels. Further, obesity as well as higher doses of prednisone and nonsteroidal anti-inflammatory drugs were also risk factors for developing nonalcoholic fatty liver disease as a comorbidity of rheumatoid arthritis. The investigators concluded that patients with rheumatoid arthritis should undergo liver function tests every 3 months, and that those who are taking drugs with potential liver toxicities should undergo testing once per month.