Lupus & antiphospholipid syndrome
Long-term outcomes of hydroxychloroquine dose reduction in Puerto Ricans with systemic lupus erythematosus: 6-year follow-up
Authors' conclusion
In this cohort, reducing HCQ to ≤5.0 mg/kg/day was associated with a slight increase in long-term disease damage. No adverse outcomes on disease activity, exacerbations or hospitalisations were observed
Study context
- Population
- Puerto Rican patients with systemic lupus erythematosus (SLE)
- Participants
- 304 patients
- Exposure
- Hydroxychloroquine (HCQ) dose adjusted to ≤5.0 mg/kg/day vs no HCQ dose adjustment; 4-year extension vs preadjustment and initial 2-year postadjustment periods
- Adjusted dosen = 60
- Controlsn = 244reference
- Outcome
- Disease activity (SLEDAI), lupus exacerbations, hospitalisations, disease damage (SLICC/ACR DI) and pharmacologic treatments
- Follow-up
- 4-year extension (6 years post-HCQ dose adjustment)
Methodological detailscontrolled (patients not requiring HCQ dose adjustment), 6-year follow-up
- Controlled (patients not requiring HCQ dose adjustment)
- 6-year follow-up
Main finding
As reported in the abstract
Outcomes during 4-year extension in adjusted-dose patients vs earlier follow-up periods
- Small but statistically significant increase in disease damage vs earlier follow-up periods
- Tacrolimus exposure significantly increased; other immunosuppressive therapies remained stable
- No increase in disease activity, lupus exacerbations or hospitalisations
Observational data: associations, not effects.
Further findings
Adjusted dose vs Controls
- Clinical features comparable; adjusted-dose group had lower weight-based daily HCQ dosing
Safety
- Adjusted-dose group less likely to develop HCQ-induced retinopathy than controls
Original publication
Long-term outcomes of hydroxychloroquine dose reduction in Puerto Ricans with systemic lupus erythematosus: 6-year follow-up. Lupus Sci Med. Published 24 March 2026. doi:10.
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