Arthritis Rheumatol:羟氯喹血药浓度可以预测羟氯喹视网膜病变

2019-09-23 xiangting MedSci原创

这项研究数据证明了羟氯喹血药水平在预测视网膜病变中的实用性。

2016年,美国眼科学会(AAO)将羟氯喹的推荐剂量从6.5mg/kg改为小于5mg/kg。然而,低剂量的羟氯喹对SLE活动性是否具有相同疗效或对心血管危险因素和血栓形成是否具有相同保护作用尚不清楚。这里研究了羟氯喹视网膜病变的发病率和羟氯喹血药水平对于确定视网膜病变高危人群的作用。

反复评估一个大型临床队列中537SLE患者的羟氯喹血药水平,并检测羟氯喹视网膜病变。研究人员通过临床特征和血液中羟氯喹的水平评估视网膜病变的风险。

视网膜病变的总发病率为4.3%(23/537)。前5年视网膜病变的风险为1%,610年为1.8%,1115年为3.3%,1620年为11.5%,使用21年后为8.0%。研究发现老年患者(p<0.0001)、体重指数高(趋势为p=0.0160)和羟氯喹使用时间长(趋势为p=0.0024p=0.0006)与羟氯喹毒性的风险高相关。较高的羟氯喹血药水平可以预测后来的羟氯喹视网膜病(平均和最大HCQ血药浓度分别为p=0.0124p=0.0340)。

这项研究数据证明了羟氯喹血药水平在预测视网膜病变中的实用性。这有助于临床医生减少血药水平高患者的剂量或对其加强监测。

原始出处:

Michelle Petri. Hydroxychloroquine Blood Levels Predict Hydroxychloroquine Retinopathy. Arthritis Rheumatol. 18 September 2019.

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    2019-09-25 zutt
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    2019-09-25 zhaojie88
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