Retinal toxicity in a multinational inception cohort of patients with systemic lupus on hydroxychloroquine

被引：9

作者：

Almeida-Brasil, Celline C. ^{[1
]}

Hanly, John G. ^{[2
]}

Urowitz, Murray ^{[3
]}

Clarke, Ann Elaine ^{[4
]}

Ruiz-Irastorza, Guillermo ^{[5
]}

Gordon, Caroline ^{[6
]}

Ramsey-Goldman, Rosalind ^{[7
]}

Petri, Michelle A. ^{[8
]}

Ginzler, Ellen M. ^{[9
]}

Wallace, Daniel J. ^{[10
]}

Bae, Sang-Cheol ^{[11
]}

Romero-Diaz, Juanita ^{[12
]}

Dooley, Mary-Anne ^{[13
]}

Peschken, Christine ^{[14
]}

Isenberg, David ^{[15
]}

Rahman, Anisur ^{[15
]}

Manzi, Susan ^{[16
]}

Jacobsen, Soren ^{[17
]}

Lim, S. Sam ^{[18
]}

van Vollenhoven, Ronald ^{[19
]}

Nived, Ola ^{[20
]}

Joensen, Andreas ^{[20
]}

Kamen, Diane L. ^{[21
]}

Aranow, Cynthia ^{[22
]}

Sanchez-Guerrero, Jorge ^{[23
]}

Gladman, Dafna D. ^{[23
]}

Fortin, Paul R. ^{[24
]}

Alarcon, Graciela S. ^{[25
]}

Merrill, Joan T. ^{[26
]}

Kalunian, Kenneth ^{[27
]}

Ramos-Casals, Manuel ^{[28
]}

Steinsson, Kristjan ^{[29
]}

Zoma, A. ^{[30
]}

Askanase, Anca D. ^{[31
]}

Khamashta, Munther ^{[32
]}

Bruce, Ian N. ^{[33
]}

Inanc, Murat ^{[34
]}

Lukusa, Luck ^{[1
]}

Bernatsky, Sasha ^{[1
,35
]}

机构：

[1] McGill Univ Hlth Ctr, Ctr Outcomes Res & Evaluat CORE, Res Inst, Montreal, PQ, Canada

[2] Dalhousie Univ, Rheumatol, Halifax, NS, Canada

[3] Univ Toronto, Toronto Western Hosp, Schroeder Arthrit Inst, Krembil Res Inst, Toronto, ON, Canada

[4] Univ Calgary, Cumming Sch Med, Div Rheumatol, Calgary, AB, Canada

[5] Biocruces Bizkaia Hlth Res Inst, Autoimmune Dis Res Unit, Baracaldo, Spain

[6] Univ Birmingham, Rheumatol Res Grp, Birmingham, England

[7] Northwestern Univ, Med Rheumatol, Evanston, IL USA

[8] Johns Hopkins Univ, Div Rheumatol, Sch Med, Baltimore, MD USA

[9] SUNY Downstate Med Ctr, Med Rheumatol, New York, NY USA

[10] Univ Calif Los Angeles, Cedars Sinai Med Ctr, Cedars Sinai David Geffen Sch Med, Los Angeles, CA USA

[11] Hanyang Univ, Hanyang Univ Hosp Rheumat Dis, Inst Rheumatol, Rheumatol,Inst Biosci & Biotechnol, Seoul, South Korea

[12] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Immunol & Rheumatol, Mexico City, Mexico

[13] Univ North Carolina Chapel Hill, Med, Chapel Hill, NC USA

[14] Univ Manitoba, Rheumatol, Winnipeg, MB, Canada

[15] UCL, Med Rheumatol, London, England

[16] Allegheny Hlth Network, Allegheny Singer Res Inst, Pittsburgh, PA USA

[17] Copenhagen Univ Hosp, Copenhagen Lupus & Vasculitis Clin, Ctr Rheumatol & Spine Dis, Copenhagen, Denmark

[18] Emory Univ, Sch Med, Atlanta, GA USA

[19] Amsterdam Rheumatol & Immunol Ctr, Dept Rheumatol, Amsterdam, Netherlands

[20] Lund Univ, Dept Clin Sci, Rheumatol, Fac Med, Lund, Sweden

[21] Med Univ South Carolina, Med, Charleston, SC USA

[22] Feinstein Inst Med Res Fertil Res Lab, Autoimmune & Musculoskeletal Dis, Manhasset, NY USA

[23] Toronto Western Hosp, Ctr Prognosis Studies Rheumat Dis, Toronto, ON, Canada

[24] Univ Laval, Med Rheumatol, Quebec City, PQ, Canada

[25] Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Med, Birmingham, AL USA

[26] Oklahoma Med Res Fdn, Arthrit & Clin Immunol Program, Oklahoma City, OK USA

[27] Univ Calif San Diego, Div Rheumatol Allergy & Immunol, La Jolla, CA USA

[28] Univ Barcelona, Hosp Clin, Dept Autoimmune Dis, Barcelona, Spain

[29] Landspitali Univ Hosp, Dept Obstet & Gynecol, Rheumatol, Reyjavik, Iceland

[30] Hairmyres Hosp, Lanarkshire Ctr Rheumatol, East Kilbride, Scotland

[31] Columbia Univ, Rheumatol, Med Ctr, New York, NY USA

[32] St Thomas Hosp, Rayne Inst, London, England

[33] Univ Manchester, Arc Epidemiol Unit, Manchester, England

[34] Istanbul Univ, Internal Med Rheumatol, Istanbul, Turkey

[35] McGill Univ Hlth Ctr, Div Rheumatol, Montreal, PQ, Canada

来源：

LUPUS SCIENCE & MEDICINE | 2022年 / 9卷 / 01期

关键词：

epidemiology; lupus erythematosus; systemic; outcome assessment; health care; RISK; CHLOROQUINE; RETINOPATHY; ADHERENCE; DISEASE; INDEX;

D O I：

10.1136/lupus-2022-000789

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveTo evaluate hydroxychloroquine (HCQ)-related retinal toxicity in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.MethodsData were collected at annual study visits between 1999 and 2019. We followed patients with incident SLE from first visit on HCQ (time zero) up to time of retinal toxicity (outcome), death, loss-to-follow-up or end of study. Potential retinal toxicity was identified from SLICC Damage Index scores; cases were confirmed with chart review. Using cumulative HCQ duration as the time axis, we constructed univariate Cox regression models to assess if covariates (ie, HCQ daily dose/kg, sex, race/ethnicity, age at SLE onset, education, body mass index, renal damage, chloroquine use) were associated with HCQ-related retinal toxicity.ResultsWe studied 1460 patients (89% female, 52% white). Retinal toxicity was confirmed in 11 patients (incidence 1.0 per 1000 person-years, 0.8% overall). Average cumulative time on HCQ in those with retinal toxicity was 7.4 (SD 3.2) years; the first case was detected 4 years after HCQ initiation. Risk of retinal toxicity was numerically higher in older patients at SLE diagnosis (univariate HR 1.05, 95% CI 1.01 to 1.09).ConclusionsThis is the first assessment of HCQ and retinal disease in incident SLE. We did not see any cases of retinopathy within the first 4 years of HCQ. Cumulative HCQ may be associated with increased risk. Ophthalmology monitoring (and formal assessment of cases of potential toxicity, by a retinal specialist) remains important, especially in patients on HCQ for 10+ years, those needing higher doses and those of older age at SLE diagnosis.

引用

页数：6

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