Sharp decline in hydroxychloroquine dosing—analysis of 17,797 initiators from 2007 to 2016
| Autor: | Ronald B. Melles, Michael F. Marmor, April Jorge, Yuqing Zhang, Hyon K. Choi |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Logistic regression Article 03 medical and health sciences 0302 clinical medicine Rheumatology Retinal Diseases Internal medicine Epidemiology medicine Humans Lupus Erythematosus Systemic Drug Dosage Calculations Dosing Medical prescription 030203 arthritis & rheumatology business.industry Hydroxychloroquine General Medicine Odds ratio Guideline Middle Aged medicine.disease Logistic Models Rheumatoid arthritis Antirheumatic Agents 030221 ophthalmology & optometry Female Guideline Adherence business medicine.drug |
| Popis: | We aimed to assess the impact of ophthalmology weight-based hydroxychloroquine (HCQ) dosing guidelines on prescribing patterns. We examined initial HCQ prescription dosing between 2007 and 2016 and determined independent predictors for HCQ dosing above the previous (2011) recommended ≤ 6.5 mg/kg of ideal body weight (IBW)/day and the latest (2016) recommended ≤ 5.0 mg/kg of actual body weight (ABW)/day using logistic regression. Among 17,797 patients (82% female), the proportion of 400 mg prescribed daily dosing declined sharply from 80% in 2007–2011 to nearly 40% in 2014, whereas the proportions of 200- and 300-mg daily doses showed the opposite trends during the same periods. Accordingly, the risk of HCQ dosing above the guideline recommendations declined by more than 60%. While 36% of normal body mass index (BMI) individuals were classified as dosing above the IBW-based guideline, 66% would have received dosing above the latest ABW-based guideline. The risk of excess dosing was associated with female patients and dermatology prescribers (adjusted odds ratios ≥ 2 according to IBW- or ABW-based guidelines). There has been a sharp decline in HCQ dosing following ophthalmology weight-based guidelines in recent years. While this trend is likely helpful in reducing the risk of retinopathy, its potential impact on HCQ efficacy remains to be clarified. |
| Databáze: | OpenAIRE |
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