Cardiovascular (CV) disease is a leading cause of mortality in patients with rheumatoid arthritis (RA) and there is an urgent need to prevent heart attacks in the vulnerable RA population ^[2]. RA patient plasma causes atherosclerosis-promoting disruptions in cholesterol transport leading to macrophage foam cell formation (FCF), a crucial step in atherosclerosis initiation and progression ^[3]. The TARGET randomized clinical trial is a prospective cohort study that compares CV benefits of 2 RA drug regimens: (1) methotrexate (MTX) + tumor necrosis factor inhibitor versus (2) a triple therapy of MTX + sulfasalazine + hydroxychloroquine (HCQ) ^[1]. HCQ is a medication commonly used in RA treatment and a component of  TARGET triple therapy. This study examines HCQ-induced changes in lipid handling and expression of cholesterol transport genes in a human macrophage cell line as a way to understand whether or not it might be atheroprotective in RA ^[4]. This type of cell culture model may be useful in determining optimal treatment regimens in RA and other autoimmune disorders where elevated CV risk is a key consideration and has the potential to be applied in precision medicine to tailor therapeutic combinations to the individual.