Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
Dr. Blair Solow’s Picks for the Top RA Research Presented at ACR Convergence 2020
ACR CONVERGENCE 2020—Held Nov. 5–9, the ACR’s first fully virtual annual meeting provided participants with a vast repository of new research related to rheumatoid arthritis (RA). To help you sort through the noise, Elizabeth (Blair) Solow, MD, an assistant professor of medicine in the Division of Rheumatic Diseases at UT Southwestern Medical Center, Dallas, offered …
Rheumatology in the Age of COVID-19: HCQ Shortages Driven by Small, Nonrandomized Study
No data exist for prescribing hydroxychloroquine for post-exposure prophylaxis, and we should not prescribe it for this indication.
Is Hydroxychloroquine Helpful for Patients with Antiphospholipid Syndrome?
Hydroxychloroquine is not currently used to treat patients with antiphospholipid syndrome (APS). But new research in APS-induced mice shows hydroxychloroquine may improve endothelium-dependent dilation and reduce reactive oxygen species generation…
HCQ Debate: Should Dose Be No More Than 5 mg/kg in All SLE Patients?
Multiple studies show that hydroxychloroquine (HCQ) has many benefits in systemic lupus erythematosus (SLE), including cardiovascular benefits, such as reducing coronary artery and thrombosis risks. HCQ can prevent disease flares, including in renal and central nervous system lupus, and is the only drug shown to prolong survival in lupus. However, guidelines released in 2016 by…
Promote Pregnancy Wellness: Data Can Help Guide Pregnancy Management in Lupus
AMSTERDAM—Clinicians who are counseling women with systemic lupus erythematosus (SLE) have the benefit of an array of new insights into factors linked with increased risk of pregnancy loss, how SLE therapies affect pregnancy and data on outcomes of children born to mothers with SLE, an expert said in a session at EULAR: the Annual European…
Hydroxychloroquine Risk-Benefit Discussion, & a Handy Dosage App
CHICAGO—As good an option as hydroxychloroquine (HCQ) is for many patients with rheumatic diseases, such as rheumatoid arthritis and especially lupus, safety must be an important consideration, an expert said at this April’s ACR State-of-the-Art Clinical Symposium. The use of the antimalarial has become a controversial subject, with clinicians trying to balance the drug’s disease-modifying…
Effectiveness of Retinoic Acid, Hydroxychloroquine Examined for Hand OA
The Osteoarthritis Research Society International (OARSI) held the 2017 OARSI World Congress in Las Vegas, April 27–30. Below, we report on two of the sessions held. Retinoic Acid & Hand Osteoarthritis Retinoic acid is a vitamin A derivative and hormonal signaling molecule with a role in cartilage and skeletal development. Retinoic acid has complex function,…
Revised Retinopathy Screening Guidelines State Risks Linked to Hydroxychloroquine, Chloroquine
A large medical specialty society for ophthalmologists recently updated its recommendations for the screening of chloroquine (CQ) and hydroxychloroquine (HCQ) retinopathy.1 The recommendations from the American Academy of Ophthalmology (AAO) affect patients who may use CQ or HCQ for rheumatoid arthritis or systemic lupus erythematosus (SLE), as well as some inflammatory and dermatologic conditions. The…
Ocular Disease Monitoring Critical to Avoid Retinal Toxicity from Hydroxychloroquine
Both due to its efficacy and favorable side effect profile when compared with alternative drugs for rheumatologic conditions, hydroxychloroquine is an important agent in rheumatologists’ armamentarium. However, one barrier to hydroxychloroquine use can be its effects on the eye (also see “Revised Retinopathy Screening Guidelines,”). Ocular side effects of hydroxychloroquine can include impact on the…