ArticleBMC rheumatology2025
Associations between hydroxychloroquine dose and risk of flares in systemic lupus erythematosus.
Article in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate the relationship between Hydroxychloroquine (HCQ) dosage and the incidence of flares in Systemic Lupus Erythematosus (SLE) flare incidence.
methodsThis retrospective cohort study analysed 703 SLE patients (Systemic Lupus Erythematosus Disease Activity Index 2000, SLEDAI-2 K ≥ 4) from multiple Chinese centres (2020-2023). Patients were stratified by HCQ dose into low-dose (≤ 6.5 mg/kg/day) and high-dose (> 6.5 mg/kg/day) HCQ groups. The primary outcome was SLE flare incidence (therapy augmentation, SLEDAI-2 K increase ≥ 4, or SLE-related hospitalisation.
resultsAmong the 703 patients, 45.5% experienced flares. Flare incidence was significantly lower in the high-dose group (41.0% vs. 51.5%, P = 0.006). High-dose HCQ reduced flare risk (fully adjusted HR 0.77, 95% CI 0.61-0.97, P = 0.024) and prolonged flare-free survival (P = 0.011). Dose-response analysis showed a linear reduction in flare risk with increasing HCQ doses. Sensitivity analyses using 5 mg/kg/day cutoff and cumulative dose yielded consistent results.
conclusionsHigher HCQ dosages are associated with a reduced SLE flares risk, and improved flare-free survival, supporting individualized dosing within safety guidelines. CLINICAL
trial registrationNot applicable.
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