AI Article Synopsis
- Hydroxychloroquine (HCQ) is the main treatment for systemic lupus erythematosus (SLE), but its use varies widely among clinicians. A consensus was created to standardize recommendations for healthcare providers.
- A systematic literature review led to the identification of relevant studies, resulting in a total of 11 recommendations for the appropriate use of HCQ, covering initiation, maintenance, and monitoring. All committee members unanimously agreed on these guidelines.
- The evidence supports HCQ's safety and effectiveness, emphasizing the importance of tailored dosing and careful monitoring to balance treatment benefits against risks, particularly concerning retinal toxicity and SLE flare-ups.
Article Abstract
Background: Hydroxychloroquine (HCQ) is the first-line treatment for systemic lupus erythematosus (SLE); however, there is heterogeneity in its clinical use. This consensus aims to bridge the gap in SLE treatment by providing practical and valuable recommendations for health professionals.
Methods: The methodology used is based on a systematic literature review and a nominal group technique (NGT). A ten-member scientific committee formulated eight clinically relevant questions. First, a systematic review was conducted to identify the available evidence, which the scientific committee evaluated to developed recommendations based on their expertise, achieving consensus through NGT.
Results: 1673 titles and abstracts were screened, and 43 studies were included for meeting the inclusion criteria. The scientific committee established 11 recommendations for HCQ use in initiation, maintenance, and monitoring, considering benefits and potential adverse effects of HCQ. Unanimous agreement was achieved on all recommendations.
Conclusions: The available evidence supports HCQ's effectiveness and safety for SLE. Individualized assessment of the initial HCQ dose is important, especially in situations requiring dose reduction or discontinuation. This risk-benefit assessment, specifically focusing on the balance between retinal toxicity and the risk of SLE relapse, should guide decisions regarding medication withdrawal, considering disease activity, risk factors, and HCQ potential benefits. Close monitoring is essential for optimal disease management and minimize potential risks, such as QT prolongation or retinal toxicity.
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| http://dx.doi.org/10.1016/j.reumae.2024.03.002 | DOI Listing |
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