Related Experiment Video
Updated: May 10, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Higher hydroxychloroquine dose based on actual body weight is associated with lower SLE flare risks while maintaining
Shotaro Yamamoto1, Takeo Sato1, Katsuya Nagatani1
1Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Objectives:
The effects of HCQ dose based on actual body weight (ABW) on SLE remain unclear. We investigated the effects of HCQ dose based on ABW of patients with SLE.
Methods:
Patients were classified into ≥5 mg/kg ABW [high dose (HD)] and <5 mg/kg ABW [low dose (LD)] groups. Patient backgrounds were adjusted using inverse probability of treatment weighting method. The discontinuation rate owing to adverse events of overall cohort (group 1) was evaluated. Subgroups with a disease duration ≥1 year (group 2) and without additional immunosuppressive agents and biologics after HCQ initiation (group 3) were compared with evaluated flare rates, prednisolone dose and serological data.
Results:
Among 182 patients in group 1, 60 (33%) comprised the HD group. Five-year discontinuation rates were 18.9% and 13.6% in the HD and LD groups, respectively (P = 0.314). Three-year flare-free rates in HD group were higher than those in LD group: 75.0% (HD) vs 60.7% (LD) (P = 0.239) in group 2, and 79.2% (HD) vs 57.8% (LD) (P = 0.141) in group 3. In group 3, each 0.2 mg/kg increase in the HCQ dose reduced flares (hazard ratio 0.91; 95% CI 0.84-0.99).
Conclusion:
No clear differences in efficacy and safety were observed between the HD and LD groups; however, a higher HCQ dose was associated with a reduced flare risk. Our findings suggest that a lower HCQ dose may be associated with a higher flare risk in patients with SLE, highlighting the importance of HCQ dose based on ABW.
Related Concept Videos
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment
Drug Dosing: Obese Patients
Rational Dosage Regimen: Maintenance Dose and Loading Dose
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady state,...
Dosage Regimen: Individualization
Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...