Risk of flare in patients with SLE in remission after hydroxychloroquine or chloroquine withdrawal

被引：3

作者：

Trefond, Ludovic ^{[1
,2
]}

Mathian, Alexis ^{[1
,3
]}

Lhote, Raphael ^{[1
]}

De Chambrun, Marc Pineton ^{[4
]}

Pha, Micheline ^{[1
]}

Hie, Miguel ^{[1
]}

Miyara, Makoto ^{[3
,5
]}

Papo, Matthias ^{[6
]}

Moyon, Quentin ^{[6
]}

Taieb, Dov ^{[1
]}

Abdallah, Nassim Ait ^{[1
]}

Chasset, Francois ^{[3
,6
,7
]}

Aubart, Fleur Cohen ^{[6
]}

Haroche, Julien ^{[3
,6
]}

Zahr, Noel ^{[8
]}

Amoura, Zahir ^{[3
,6
]}

机构：

[1] Grp Hosp Pitie Salpetriere, AP HP, Inst E3M, Ctr & Martinique,Ctr Reference Malad Autoimmunes &, Paris, France

[2] Univ Clermont Auvergne, CHU Gabriel Montpied, Med Interne, Inserm,UMR,M2iSH, F-63000 Clermont Ferrand, France

[3] Sorbonne Univ, Ctr Immunol & Malad Infect CIMI Paris, Inserm, Paris, France

[4] Hop La Pitie Salpetriere, AP HP, Inst Cardiol, Serv Med Intens Reanimat, Paris, France

[5] Sorbonne Univ, Grp Hosp Pitie Salpetriere, AP HP, Dept Immunol, Paris, France

[6] Sorbonne Univ, Grp Hosp Pitie Salpetriere, AP HP, Inst E3M,Ctr Reference Malad Autoimmunes & Autoinf, Paris, France

[7] Sorbonne Univ, Hop Tenon, AP HP, Fac Med,Serv Dermatol & Allergol, Paris, France

[8] Sorbonne Univ, Pitie Salpetriere Hosp, AP HP, Dept Pharmacol,Pharmacokinet & Therapeut Drug Moni, F-75013 Paris, France

来源：

JOINT BONE SPINE | 2024年 / 91卷 / 06期

关键词：

Systemic lupus erythematosus; Hydroxychloroquine; Chloroquine; Retinopathy; SYSTEMIC-LUPUS-ERYTHEMATOSUS; DISEASE-ACTIVITY; LONG-TERM; RECOMMENDATIONS; PHARMACOKINETICS; RETINOPATHY; MANAGEMENT; PREGNANCY; DAMAGE; HCQ;

D O I：

10.1016/j.jbspin.2024.105756

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: Previous studies have provided evidence that the discontinuation of hydroxychloroquine (HCQ), and chloroquine (CQ), in patients with systemic lupus erythematosus (SLE) is associated with an increased risk of disease flares, with limited information on the level of disease activity at the time of HCQ/CQ discontinuation. Here we aimed to describe the risk of SLE flare after withdrawal of HCQ or CQ in patients with SLE in remission. Methods: Case-control study (1:2) comparing the evolution of patients with SLE after HCQ/CQ withdrawal for antimalarial retinopathy (cases) with patients with SLE matched for sex, antimalarial treatment duration and age at SLE diagnosis, whose antimalarial treatment was continued throughout the entire follow-up period (controls). To be included in the study, patients had to be in remission for at least one year according to the DORIS classification. The primary endpoint was the proportion of patient experiencing a flare according to the SELENA-SLEDAI Flare Index after a 36-month follow-up. Results: We studied 48 cases and 96 controls. The proportion of patients experiencing a flare was significantly higher in the HCQ/CQ withdrawal group as compared to the maintenance group (15 [31.3%] patients versus 12 [12.5%]; OR 3.1 [95%CI 1.2-8.2], P = 0.01). Withdrawal of HCQ/CQ was inferior with respect to occurrence of severe SLE flare (12 [25.0%] vs 11 [11.5%]; OR 2.5 [95%CI 0.9-6.9], P = 0.053) and time to first flare (HR 6.3 [2.0-19.9], P < 0.005). Elevated serum levels of anti-dsDNA antibodies were identified as a risk factor for SLE flare following HCQ/CQ discontinuation (HR 5.4 [1.5-18.7], P < 0.01). Conclusion: Withdrawal of HCQ or CQ in patients with SLE in remission is associated with a 3-fold increased risk of relapse. (c) 2024 Socioto Franoaise de Rhumatologie. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页数：6

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