CS-31 Safety of hydroxychloroquine withdrawal in older adults with systemic lupus erythematosus

Izmirly, Peter; Bornkamp, Nicole; Zezon, Anna; Tseng, Chung‐E; Belmont, H. Michael; Askanase, Anca; Salmon, Jane E.; Lockshin, Michael D.; Buyon, Jill P.

doi:10.1136/lupus-2018-lsm.66

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…There have been many reports of clinical flare-up following discontinuation of HCQ, with various manifestations, including pancreatitis, haemorrhagic alveolitis, nephritis, arthritis, rash and so on. 6–8 None has mentioned ocular complications. However, there is one report by El-Asrar et al.…”

Section: Discussionmentioning

confidence: 99%

Ocular flare-up in patients with systemic lupus erythematosus following discontinuation of hydroxychloroquine

Ebrahimiadib

Riazi-Esfahani

Heidari

et al. 2020

Lupus

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In this report, we describe two patients with systemic lupus erythematosus (SLE) who manifested with posterior segment flare-up approximately three months after cessation of hydroxychloroquine (HCQ). They were stable systemically with no history of hypertension or nephropathy at the time of referral. Our first patient presented with bilateral retinal vein occlusion, while evidence of choroidal involvement such as vascular leakage and wedge-shaped filling delay was present in indocyanine green angiography of both patients. HCQ is well known to have a role in the treatment of SLE for its immunomodulatory and antithrombotic effects. Although reports of systemic flare-up of SLE following HCQ cessation exist in the literature, this is the first report of ocular flare-up in such settings.

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Section: Discussionmentioning

confidence: 99%

Ocular flare-up in patients with systemic lupus erythematosus following discontinuation of hydroxychloroquine

Ebrahimiadib

Riazi-Esfahani

Heidari

et al. 2020

Lupus

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Self-Reported Symptoms in a Cohort of Rheumatoid Arthritis and Systemic Lupus Erythematosus during the COVID-19 Quarantine Period

Salido¹,

Tee²,

Reyes³

et al. 2021

TORJ

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Background: During the first three months of the COVID-19 pandemic in the Philippines, there was a supply shortage of hydroxychloroquine and methotrexate. Limited access to medication and the life changes resulting from the COVID-19 pandemic may predispose patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) to disease flares. Objective: This study aimed to investigate self-reported symptoms of disease flares among patients with rheumatoid arthritis or systemic lupus erythematosus during the COVID-19 pandemic. Methods: A total of 512 completed online surveys from patients with SLE or RA were collected. The data included sociodemographic characteristics, self-reported physical symptoms, health service utilization, and availability of hydroxychloroquine and methotrexate. Results: Seventy-nine percent of respondents had lupus, while 21% had RA. One-third of the cohort had contact with their attending physician during the two-month quarantine period prior to the survey. Eighty-two percent were prescribed hydroxychloroquine and 23.4% were prescribed methotrexate; but 68.6% and 65%, respectively, had “irregular” intake of these medicines due to unavailability. The current health status was reported as good by 66.2%; 24% had no symptoms during the two-week period prior to the survey. The most common symptoms experienced were joint pain (51%), muscle pain (35%), headache (26.8%), and skin rash (19.1%). Five percent had a combination of these four most common symptoms. Irregular supply of hydroxychloroquine among patients with SLE (n=323) was associated with more frequent occurrence of muscle pain (40.6% vs 27.9%, p=0.03) or rash (27.4% vs 11.7%, p<0.001). Irregular supply of methotrexate among RA patients prescribed hydroxychloroquine and methotrexate (n=36) was associated with more frequent occurrence of joint pains with or without swelling (73.9% vs 38.5%, p=0.04). Irregular supply of hydroxychloroquine was associated with less frequent occurrence of dizziness (0 vs 66.7%, p<0.001) among RA patients (n=18). Conclusion: In our cohort of RA and SLE, the majority reported at least one symptom that may indicate disease flare. There was a significant association between the irregular supply of hydroxychloroquine or methotrexate with the presence of muscle pain, rash, or joint pains during the 14-day period prior to the survey.

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CS-31 Safety of hydroxychloroquine withdrawal in older adults with systemic lupus erythematosus

Cited by 2 publications

References 3 publications

Ocular flare-up in patients with systemic lupus erythematosus following discontinuation of hydroxychloroquine

Ocular flare-up in patients with systemic lupus erythematosus following discontinuation of hydroxychloroquine

Self-Reported Symptoms in a Cohort of Rheumatoid Arthritis and Systemic Lupus Erythematosus during the COVID-19 Quarantine Period

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