Original articleThe effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study
Section snippets
Study design and settings
We conducted an open-label prospective study between 2010 and 2014, including patients with CLE followed up in 2 dermatology departments of French university hospitals (Hôpital Tenon, Paris, and Hôpital Saint-Eloi, Centre Hospitalier Régional Universitaire [CHRU] Montpellier).
Participants and inclusion criteria
Eligible patients were consecutively included if they had chronic, intermittent, or subacute CLE with pathological confirmation; received HCQ treatment for 3 months or longer; had active CLE defined by a CLE Disease Area
Patient characteristics
In our cohort of 74 patients with refractory CLE, 36 (49%) had HCQ blood concentration less than 750 ng/mL. Among them 34 were included in the study protocol. Two of these 34 patients were excluded from further analyses because they discontinued therapy as a result of poor adherence without reporting any side effect of HCQ. In all, 25 patients (78%) were women and the median age was 45 (range 28-72) years. The demographic and disease characteristics of the 32 patients analyzed are shown in
Discussion
In this study, increasing HCQ blood concentrations higher than 750 ng/mL was associated with a significant cutaneous improvement in 26 (81%) of 32 patients with refractory CLE. We believe this is an important message as refractory CLE represents approximately 30% of cases2 and is commonly treated by use of more toxic treatment that could therefore be avoided.
Monitoring of HCQ treatment through the development of whole-blood concentration measurement has highlighted significant
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Cited by (0)
Supported by a grant of the French Society of Dermatology. There was no other financial support or other benefit from commercial sources. The sponsors had no role in the design and conduct of the study; in the collection, analysis, or interpretation of data; or in the preparation, review, or approval of the manuscript.
Conflicts of interest: None declared.