Lupus & antiphospholipid syndrome
Relationship between hydroxychloroquine blood levels and lupus activity through the lens of the type 1 and type 2 lupus model: a cross-sectional study
Authors' conclusion
Low HCQ levels are associated with increased type 1 and type 2 SLE activities, particularly for the mixed activity group, suggesting that immunologic activity may contribute to type 2 symptoms in some patients.
Study context
- Population
- Patients with SLE (median age 43, 90% women, 63% Black race, 7% Hispanic ethnicity)
- Participants
- 154 patients297 visits
- Exposure
- Whole blood hydroxychloroquine (HCQ) levels and type 1 and type 2 SLE activity
- Outcome
- Association of HCQ levels with type 1 (type 1 Physician Global Assessment (PGA), SLEDAI) and type 2 (type 2 PGA, polysymptomatic distress) SLE activity
Main finding
As reported in the abstract
- Underexposed HCQ levels independently associated with higher type 1 activity, OR
- 2.33 (95% CI 1.23 to 4.44)
- Underexposed HCQ levels independently associated with higher type 2 activity, OR
- 1.80 (95% CI 1.07 to 3.04)
Observational data: associations, not effects.
Further findings
Activity groups (visits)
- Minimal activity
- 102 visits (34%)
- Type 1 activity
- 33 (11%)
- Type 2 activity
- 85 (29%)
- Mixed activity
- 77 (26%)
Mixed activity and underexposed HCQ levels
- Mixed activity most strongly associated with underexposed HCQ levels, OR (p<0.05)
- 3.4-10.3
Original publication
Relationship between hydroxychloroquine blood levels and lupus activity through the lens of the type 1 and type 2 lupus model: a cross-sectional study. Lupus Sci Med. Published 30 June 2025. doi:10.
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