Health status and concomitant prescription of immunosuppressants are risk factors for hydroxychloroquine non-adherence in systemic lupus patients with prolonged inactive disease
| Autor: | F. Dal Piaz, Bruno Charlier, Amelia Filippelli, Ilenia Pantano, L. Pierro, Serena Fasano, Michele Iudici, Viviana Izzo, Marine Pascal Pingeon |
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| Přispěvatelé: | Iudici, M, Pantano, I, Fasano, S, Pierro, L, Charlier, B, Pingeon, M, Dal Piaz, F, Filippelli, A, Izzo, V. |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Self-Assessment medicine.medical_specialty hydroxychloroquine Health Status Disease treatment adherence Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Systemic lupus erythematosus Rheumatology Quality of life Risk Factors Internal medicine medicine Humans Lupus Erythematosus Systemic Patient Reported Outcome Measures 030212 general & internal medicine Medical prescription quality of life Depression (differential diagnoses) Whole blood 030203 arthritis & rheumatology business.industry Chloroquine Hydroxychloroquine Middle Aged Treatment Adherence and Compliance Italy Antirheumatic Agents Concomitant Physical therapy Anxiety Female medicine.symptom business Immunosuppressive Agents medicine.drug |
| Popis: | Background/objective The objectives of this paper are to assess the extent of and the factors associated with hydroxychloroquine (HCQ) non-adherence in systemic lupus erythematosus (SLE) patients with prolonged inactive disease and to investigate relationships between blood HCQ concentration and quality of life (QoL). Methods Consecutive SLE patients, in remission for at least one year and taking a stable dose of HCQ were investigated. At study entry (T0) and six months later (T6) a blood venous sample was taken to measure whole blood concentration of [HCQ] and desethylchloroquine ([DCQ]). Moreover, at T0 each patient completed validated questionnaires assessing QoL, disability, anxiety, depression and visual analogue scales for fatigue, pain, general health (GH), and self-assessment of disease activity. Results Eighty-three patients with a median [HCQ] of 327 ng/ml were enrolled. At T0, 24 (29%) were defined as non-adherent ([HCQ] 100 ng/ml). At multiple logistic regression analysis the physical summary of SF-36 ( p = 0.038), and the concomitant use of immunosuppressants ( p = 0.010) were independently associated with non-adherence. A significant increase of HCQ adherence was observed at T6 ( p 0.05). Conclusions A better health status and the concomitant prescription of immunosuppressants represent risk factors for HCQ non-adherence in SLE patients in remission. Monitoring HCQ levels might represent an important opportunity to improve adherence. |
| Databáze: | OpenAIRE |
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