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  • Almeida-Brasil, Celline C.McGill University Health Center (author)

Retinal toxicity in a multinational inception cohort of patients with systemic lupus on hydroxychloroquine

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-11-17
  • BMJ,2022

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:39c259e9-d20f-45bf-ade0-7cb3a0417bc8
  • https://lup.lub.lu.se/record/39c259e9-d20f-45bf-ade0-7cb3a0417bc8URI
  • https://doi.org/10.1136/lupus-2022-000789DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Objective To evaluate hydroxychloroquine (HCQ)-related retinal toxicity in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort. Methods Data were collected at annual study visits between 1999 and 2019. We followed patients with incident SLE from first visit on HCQ (time zero) up to time of retinal toxicity (outcome), death, loss-to-follow-up or end of study. Potential retinal toxicity was identified from SLICC Damage Index scores; cases were confirmed with chart review. Using cumulative HCQ duration as the time axis, we constructed univariate Cox regression models to assess if covariates (ie, HCQ daily dose/kg, sex, race/ethnicity, age at SLE onset, education, body mass index, renal damage, chloroquine use) were associated with HCQ-related retinal toxicity. Results We studied 1460 patients (89% female, 52% white). Retinal toxicity was confirmed in 11 patients (incidence 1.0 per 1000 person-years, 0.8% overall). Average cumulative time on HCQ in those with retinal toxicity was 7.4 (SD 3.2) years; the first case was detected 4 years after HCQ initiation. Risk of retinal toxicity was numerically higher in older patients at SLE diagnosis (univariate HR 1.05, 95% CI 1.01 to 1.09). Conclusions This is the first assessment of HCQ and retinal disease in incident SLE. We did not see any cases of retinopathy within the first 4 years of HCQ. Cumulative HCQ may be associated with increased risk. Ophthalmology monitoring (and formal assessment of cases of potential toxicity, by a retinal specialist) remains important, especially in patients on HCQ for 10+ years, those needing higher doses and those of older age at SLE diagnosis.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Hanly, John G.Dalhousie University (author)
  • Urowitz, MurrayUniversity of Toronto (author)
  • Clarke, Ann ElaineCumming School of Medicine (author)
  • Ruiz-Irastorza, GuillermoBiocruces Bizkaia Health Research Institute (author)
  • Gordon, CarolineUniversity of Birmingham (author)
  • Ramsey-Goldman, RosalindNorthwestern University (author)
  • Petri, Michelle A.Johns Hopkins University School of Medicine (author)
  • Ginzler, Ellen M.SUNY Downstate Health Sciences University (author)
  • Wallace, Daniel J.Cedars-Sinai Medical Center (author)
  • Bae, Sang CheolHanyang University Hospital for Rheumatic Disease (author)
  • Romero-Diaz, JuanitaSalvador Zubirán National Institute of Health Sciences and Nutrition (author)
  • Dooley, Mary AnneUniversity of North Carolina (author)
  • Peschken, ChristineUniversity of Manitoba (author)
  • Isenberg, DavidUniversity College London (author)
  • Rahman, AnisurUniversity College London (author)
  • Manzi, SusanAllegheny Health Network (author)
  • Jacobsen, SørenCopenhagen University Hospital (author)
  • Sam Lim, S.Emory University (author)
  • Van Vollenhoven, RonaldAmsterdam Rheumatology and Immunology Center (author)
  • Nived, OlaLund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)reum-oni (author)
  • Jönsen, AndreasLund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)reum-ajo (author)
  • Kamen, Diane L.Medical University of South Carolina (author)
  • Aranow, CynthiaFeinstein Institute for Medical Research (author)
  • Sánchez-Guerrero, JorgeToronto Western Hospital (author)
  • Gladman, Dafna D.Toronto Western Hospital (author)
  • Fortin, Paul R.Laval University (author)
  • Alarcon, Graciela S.University of Alabama (author)
  • Merrill, Joan T.Oklahoma Medical Research Foundation (author)
  • Kalunian, KennethUniversity of California, San Diego (author)
  • Ramos-Casals, ManuelUniversity of Barcelona (author)
  • Steinsson, KristjanNational University Hospital of Iceland (author)
  • Zoma, A.Hairmyres Hospital (author)
  • Askanase, Anca D.Columbia University (author)
  • Khamashta, MuntherSt Thomas' Hospital (author)
  • Bruce, Ian N.University of Manchester (author)
  • Inanc, MuratIstanbul University (author)
  • Lukusa, LuckMcGill University Health Center (author)
  • Bernatsky, SashaMcGill University Health Center (author)
  • McGill University Health CenterDalhousie University (creator_code:org_t)

Related titles

  • In:Lupus Science and Medicine: BMJ9:12053-8790

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