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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Associations between hydroxychloroquine dose and risk of flares in systemic lupus erythematosus
Yadan Zou1,2, Yuanhong Peng3, Yuchao Zhong4
1Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China.
Objectives:
To evaluate the relationship between Hydroxychloroquine (HCQ) dosage and the incidence of flares in Systemic Lupus Erythematosus (SLE) flare incidence.
Methods:
This retrospective cohort study analysed 703 SLE patients (Systemic Lupus Erythematosus Disease Activity Index 2000, SLEDAI-2 K ≥ 4) from multiple Chinese centres (2020-2023). Patients were stratified by HCQ dose into low-dose (≤ 6.5 mg/kg/day) and high-dose (> 6.5 mg/kg/day) HCQ groups. The primary outcome was SLE flare incidence (therapy augmentation, SLEDAI-2 K increase ≥ 4, or SLE-related hospitalisation.
Results:
Among the 703 patients, 45.5% experienced flares. Flare incidence was significantly lower in the high-dose group (41.0% vs. 51.5%, P = 0.006). High-dose HCQ reduced flare risk (fully adjusted HR 0.77, 95% CI 0.61-0.97, P = 0.024) and prolonged flare-free survival (P = 0.011). Dose-response analysis showed a linear reduction in flare risk with increasing HCQ doses. Sensitivity analyses using 5 mg/kg/day cutoff and cumulative dose yielded consistent results.
Conclusions:
Higher HCQ dosages are associated with a reduced SLE flares risk, and improved flare-free survival, supporting individualized dosing within safety guidelines.
Clinical Trial Registration:
Not applicable.
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