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Should Hydroxychloroquine Level Testing Be Standard Care in Lupus?
The Johns Hopkins Lupus Center, Baltimore, has described its experience using hydroxychloroquine (HCQ) levels.1 Forty-four percent of its patients had levels below 500 ng/mL (partial nonadherence); 13% were severely nonadherent (<200 ng/mL). They were shown their results and educated on HCQ adherence. Adherence then improved to 80%; those with lower HCQ levels had higher disease…
Rheumatologists Should Discuss with Patients Use of Immunomodulatory Agents During Pregnancy
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…