Both real, ideal weight used in hydroxychloroquine toxicity screening for some patients
Click Here to Manage Email Alerts
While guideline-based protocols for hydroxychloroquine dosing adequately protect the majority of individuals, calculations can be “complicated” in vulnerable patients, according to a speaker.
“The problem is with the outliers,” Yasha Modi, MD, of New York University, said at the virtual OSN New York Retina meeting.
In outlier patients, Modi suggested considering both ideal body weight dosing as well as real body weight calculations to guide decision-making.
At NYU, the screening guidelines for hydroxychloroquine toxicity are “very much like” current guidelines from the American Academy of Ophthalmology, Modi said.
All patients undergo spectral domain OCT and visual fields testing and are followed up annually. Imaging is not required for the first 5 years if they have no risk factors, but patients with any risk factors, such as having renal disease or taking tamoxifen therapy, are screened yearly.
Fundus autofluorescence is obtained only when there is a suspicion of early signs of toxicity because this is a later-stage structural test to identify disease, Modi said.
“We follow the guidelines in the majority,” Modi said. “However, if patients are outliers, we calculate both the ideal body weight and the real body weight, and if there’s a lower dose, that is what we use in the calculation.”
Speaking with a patient’s rheumatologist is essential when discussing dose changes or cessation of hydroxychloroquine, Modi said.
“No patient should ever lose vision from this disease,” Modi said.
Collapse
Modi Y. Hydroxychloroquine screening: The majority and outlier approach. Presented at: OSN New York and OSN New York Retina; Oct. 17-18, 2020 (virtual meeting).
Read more about
Click Here to Manage Email Alerts