ArticleLupus2022
Hydroxychloroquine blood levels predicts flare in childhood-onset lupus nephritis.
Article in Lupus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Towards development of treat to target (T2T) in childhood-onset systemic lupus erythematosus: PReS-endorsed overarching principles and points-to-consider from an international task force.Annals of the rheumatic diseases · 2023Pooled it
- Hydroxychloroquine in children with proliferative lupus nephritis: a randomized clinical trial.European journal of pediatrics · 2023Trial
- Pharmacokinetics of hydroxychloroquine in paediatric lupus: data from a novel, direct-to-family clinical trial.Lupus science & medicine · 2022Trial
- Toward Optimal Dosing in Systemic Lupus Erythematosus: The Case for Hydroxychloroquine Blood Level Monitoring.Arthritis care & research · 2026Article
- A Case Series and Review of Hydroxychloroquine Toxicity and Monitoring: How Do We Dose Hydroxychloroquine?Cureus · 2025Article
- Clinical and immunological biomarkers can identify proliferative changes and predict renal flares in lupus nephritis.Arthritis research & therapy · 2025Article
- Assessment of hydroxychloroquine blood levels in Sjögren's disease patients: drug adherence and clinical associations.Rheumatology international · 2024Observational
- Reference Range of Hydroxychloroquine Blood Levels That Can Reduce Odds of Active Lupus and Prevent Flares.Arthritis care & research · 2024Article
- Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention.Current rheumatology reports · 2023Review
- Urine ALCAM, PF4 and VCAM-1 Surpass Conventional Metrics in Identifying Nephritis Disease Activity in Childhood-Onset Systemic Lupus Erythematosus.Frontiers in immunology · 2022Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveLow hydroxychloroquine (HCQ) blood levels are predictors of flare in adult lupus. Childhood-onset systemic lupus erythematosus (cSLE) has high morbidity with renal involvement in up to 80% of cases. The aim of this study is to determine the HCQ cut-off levels which predicts flare in childhood-onset lupus nephritis (LN).
methodsSixty LN patients on HCQ use for at least 6-months were prospectively evaluated at baseline (BL) and about 6-months later for cSLE flare and HCQ blood levels (ng/mL) measured by liquid chromatography-tandem mass spectrometry.
resultsThere were 19 patients (32%) with flare, during the study with median SLEDAI increase of 4 (0-8). Median (IQR) BL HCQ levels of the flare group were lower compared to stable patients [557.5 (68.6-980.3) vs. 1061.9 (534.8-1590.0 ng/mL);
conclusionsWe demonstrated that HCQ blood cut-off level under 1075 ng/mL predicts flare in childhood-onset LN patients under prescribed HCQ dose of 4.0-5.5 mg/kg/day. We further observed that most of these patients have compliance issues reinforcing the need for a close surveillance particularly in those with levels below the defined cut-off.
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