Lupus & antiphospholipid syndrome
Threshold of Hydroxychloroquine Dose Reduction Associated with Flare in Quiescent Systemic Lupus Erythematosus
Authors' conclusion
In clinically quiescent SLE, HCQ discontinuation and substantial dose reduction (≥75%) are associated with increased flare risk. These findings support cautious HCQ tapering and avoidance of marked dose reduction.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) in clinical remission (cSLEDAI-2K=0, prednisolone ≤5 mg/day, ongoing hydroxychloroquine (HCQ))patients with SLE in clinical remission
- Participants
- 381 patients
- Exposure
- HCQ dose reduction during follow-up
- Outcome
- SLE flare, defined as ≥1-point increase in clinical SLEDAI-2K or treatment escalation
- Follow-up
- Median 1.38 years
Methodological detailsadjusted Cox proportional hazards models, adjusted logistic regression, ROC analysis
- Adjusted Cox proportional hazards models
- Adjusted logistic regression
- ROC analysis
Main finding
As reported in the abstract
Estimate (95% CI)
HCQ discontinuation
aHR 1.80(1.17–2.75)
HCQ discontinuation
aOR 5.60(2.47–12.71)
≥75% reduction
aHR 1.53(1.02–2.30)
≥75% reduction
aOR 4.40(2.17–8.92)
- Developed flares (whole cohort)
- 52.5%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Flare per 10% HCQ dose reduction (logistic analysis)Dose-response relationship | 1.13 (1.06–1.21) | |
| 0.512Adjusted odds ratio (log scale) |
ROC-identified exploratory threshold for HCQ dose reduction
- Threshold reduction
- 74.7%
- AUC
- 0.55
- Exploratory
Original publication
Threshold of Hydroxychloroquine Dose Reduction Associated with Flare in Quiescent Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). Published 4 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →