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Majority of SLE patients exceeded recommended hydroxychloroquine dosages
More than 87% of patients with systemic lupus erythematosus took and tolerated daily hydroxychloroquine dosages above the recommended guidelines, according to recent study results.
Researchers in Amsterdam conducted a longitudinal cohort study in July 2012 to assess antimalarial (AM) use in 190 patients with systemic lupus erythematosus (SLE). Demographics and disease characteristics of patients who used AMs and those who didn’t use AMs were compared, and daily dosages of hydroxychloroquine (HCQ) were calculated according to lean body weight.
One hundred thirty-nine patients (73.2%; median age, 43 years; 126 women) were using AMs during their most recent visit. HCQ was used in 97.8% of cases at daily dosages of 400 mg HCQ by 115 of 136 patients (84.6%). Based on lean body weight, however, mean daily HCQ dosages were 8.81 mg/kg, which exceeded the recommended 6.5 mg/kg, in 119 of 136 patients (87.5%).
Fifty-one patients (median age, 45 years; 45 women) had never used or had discontinued AMs for intolerance (n=16), no documented reason (n=11), never initiated (n=9), quiescent disease (n=7), other (n=6) and contraindication (n=2). AM-related retinopathy was related to one patient discontinuing HCQ. Longer disease duration, higher damage accrual and a history of lupus nephritis were associated with AM nonuse.
“Despite increased awareness of the importance of AM treatment in SLE, there is still room for improvement, especially in patients with lupus nephritis and/or long-standing disease,” the researchers concluded. “Daily dosages of hydroxychloroquine often exceeded recommendations from guidelines, but are generally well-tolerated.”
Disclosure: The researchers report no relevant financial disclosures.