Should Hydroxychloroquine Level Testing Be Standard Care in Lupus?

Donald E. Thomas, MD, FACP, FACR, is an associate professor of medicine at the Uniformed Services University of the Health Sciences, Bethesda, Md., and is in private practice at Arthritis and Pain Associates of P.G. County, Greenbelt, Md.

Nathalie Costedoat-Chalumeau, MD, PhD, is a professor of internal medicine at René Descartes University and Cochin Hospital, Paris, France, and is a member of the Systemic Lupus International Collaborating Clinics (SLICC).

Michelle Petri, MD, MPH, is a professor of medicine at the Johns Hopkins University School of Medicine, Baltimore, the director of the Hopkins Lupus Center and a member of the SLICC.

Disclosure: Dr. Thomas is a member of Exagen Diagnostics’ speakers bureau.

References

1. Durcan L, Clarke WA, Magder LS, Petri M. Hydroxychloroquine blood levels in systemic lupus erythematosus: Clarifying dosing controversies and improving adherence. J Rheumatol. 2015 Nov;42(11):2092–2097.
2. Van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: Recommendations from an international task force. Ann Rheum Dis. 2014 Jun;73(6):958–967.
3. Katitanon N, et al. Hydroxychloroquine use predicts complete renal remission within 12 months among patients treated with mycophenolate mofetil therapy for membranous lupus nephritis. Lupus. 2006;15(6):366–370.
4. Marmor MF, et al. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016 Jun;123(6):1386–1394.
5. Costedoat-Chalumeau N, Galicier L, Aumaître O, et al. Hydroxychloroquine in systemic lupus erythematosus: Results of a French multicentre controlled trial (PLUS Study). Ann Rheum Dis. 2013 Nov;72(11):1786–1792.
6. Thomas DE, et al. Low hydroxychloroquine blood levels in patients who have had gastric bypass surgery. Lupus Sci Med. 2019 Jun;6(1):e000335.
7. Petri M, Elkhalifa M, Goldman D, et al. Hydroxychloroquine blood levels show significant trend test for risk for retinopathy [abstract 2897]. Arthritis Rheum. 2018;70(suppl 10).
8. Moez J, Francès C, Piette J-C, et al. Hydroxychloroquine-induced pigmentation in patients with systemic lupus erythematosus: A case-control study. JAMA Dermatol. 2013 Aug;149(8):935–940.
9. Costedoat-Chalumeau N, Tamirou F, Le Guern V, et al. [Blood concentration of hydroxychloroquine in systemic lupus erythematosus care: Usefulness and limits]. Rev Med Interne. 2017 Feb;38(2):77–80.
10. Costedoat-Chalumeau N, Amoura Z, Hulot J-S, et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006 Oct;54(10):3284–3290.