Abstract
Objective
To evaluate whether hydroxychloroquine (HCQ) dose reduction (2–3 mg/kg/day) sustain lipoprotein levels achieved with higher doses of 2016-American Academy of Ophthalmology (2016-AAO) in stable lupus nephritis (LN) patients.
Methods
Forty-seven consecutive stable LN patients using HCQ 2016-AAO recommended dose for ≥6 months were enrolled and assigned to one of two groups: Reduced HCQ group (n = 21):LN patients who, upon inclusion, reduced 2016-AAO dose (2–3 mg/kg/day); and Maintenance HCQ group (n = 26):LN patients who continued on the standard 2016-AAO recommended HCQ dose (4.0–5.5 mg/kg actual body weight, maximum 400 mg/day) throughout 12-month study period. Blood HCQ levels, lipid profile and SLE parameters (including SLEDAI-2K) were assessed at baseline, 3 and 12-month.
Results
Baseline demographics, comorbidities and disease parameters were similar among groups (p > .05). Initial blood levels of Reduced HCQ group were 1219.4 (1041.7–1926.6)ng/mL and a progressive significant decrease were identified after 3 and 12 months [651.2 (538.4–832.6)vs.468.8 (228.4–925.6)ng/mL, p < .001]. Maintenance HCQ group had no changes in HCQ levels during the study [1179.7 (905.5–1607.3)vs.1026.2 (710.5-1345.8)vs.907.9 (663.9-1304.2)ng/mL, p = .158]. No changes were observed on the longitudinal total cholesterol levels of Reduced HCQ [166 (113–198)vs.153 (85–192)vs.150 (90–231)mg/dL, p = .964] and Maintenance HCQ [155 (114–244)vs.154 (122–210)vs.155 (112–213)mg/dL, p = .395]. LDL cholesterol levels of Reduced HCQ [91 (52–163)vs.83 (41–136vs.87 (47–165)mg/dL, p = .917] and Maintenance HCQ [79 (36–114)vs.76.5 (33–111)vs.75.5 (63–131)mg/dL, p = .412] remained similar. Other lipoprotein levels remained stable during 1 year of study.
Conclusion
This is the first study to show that reducing HCQ to 2-3 mg/kg/day preserves lipid stability over 12 months in stable lupus nephritis patients.
Keywords
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