What question did this study set out to answer?

To compare whole-blood and serum hydroxychloroquine (HCQ) measurements and determine whether a reliable serum cut-off level can identify non-adherent patients with systemic lupus erythematosus (SLE).

September 25, 2020Arthritis Research & TherapyOpen Access

Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence

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To compare whole-blood and serum hydroxychloroquine (HCQ) measurements and determine whether a reliable serum cut-off level can identify non-adherent patients with systemic lupus erythematosus (SLE).
Measured paired serum and whole-blood HCQ concentrations in 573 patients with SLE.
Identified risk factors for active disease (SLEDAI score > 4) using multivariable logistic regression.
Assessed serum HCQ levels in an additional cohort of 68 known non-adherent patients (whole-blood HCQ < 200 ng/mL) to extrapolate an adherence cut-off.
Mean HCQ levels were 469 ± 223 ng/mL in serum and 916 ± 449 ng/mL in whole blood, yielding a mean serum-to-whole-blood ratio of 0.53 ± 0.15.
Low whole-blood HCQ levels were independently associated with active SLE in multivariable analysis (P = 0.023), whereas serum HCQ levels were not.
A serum HCQ cut-off of 106 ng/mL identified non-adherent patients with a sensitivity of 0.87 (95% CI 0.76–0.94) and a specificity of 0.89 (95% CI 0.72–0.98).

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Implication

Observational study demonstrates whole-blood hydroxychloroquine outperforms serum for disease activity monitoring in lupus, indicating serum remains viable for detecting non-adherence.

Cite This Study

Blanchet et al. (2020) studied this question.

synapsesocial.com/papers/6aaa13330a88a9c60a4820ed https://doi.org/10.1186/s13075-020-02291-z

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Implication

Observational study demonstrates whole-blood hydroxychloroquine outperforms serum for disease activity monitoring in lupus, indicating serum remains viable for detecting non-adherence.

Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence

Key Points

Discussion

Implication

Cite This Study

Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence

Key Points

Discussion

Implication

Cite This Study

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