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Risk of hydroxychloroquine retinopathy in the community
Jesse Y Dabit1, Mehmet Hocaoglu1,2, Kevin G Moder1
1Division of Rheumatology, Mayo Clinic, Rochester, MN.
Rheumatology (Oxford, England)
|November 17, 2021
Summary
The risk of hydroxychloroquine (HCQ) retinopathy at 10 years is lower than previously thought. Higher HCQ doses (≥5 mg/kg) increase the risk of developing this eye condition.
Area of Science:
- Ophthalmology
- Rheumatology
- Pharmacovigilance
Background:
- Hydroxychloroquine (HCQ) is widely prescribed for autoimmune conditions like rheumatoid arthritis and systemic lupus erythematosus.
- Ocular toxicity, specifically HCQ retinopathy, is a known but not fully quantified risk associated with long-term HCQ use.
Purpose of the Study:
- To estimate the incidence risk of HCQ retinopathy among new users in a community setting.
- To identify risk factors associated with the development of HCQ retinopathy.
Main Methods:
- A cohort of 634 incident HCQ users was identified using the Rochester Epidemiology Project.
- HCQ retinopathy was diagnosed based on visual field defects and retinal imaging.
- Cumulative incidence rates and risk factors were analyzed using survival analysis models.
Main Results:
- The cumulative incidence of HCQ retinopathy at 10 years was 3.9%.
- A HCQ dose of ≥5 mg/kg was associated with a significantly higher risk (HR 3.59).
- Each 100g cumulative HCQ dose increased retinopathy risk by 48% (HR 1.48).
Conclusions:
- The 10-year risk of HCQ retinopathy is lower than previously estimated.
- Daily HCQ doses of 5 mg/kg or higher are associated with an increased risk of retinopathy.
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