Lupus & antiphospholipid syndrome
Weighing Dose‐Related Benefits and Risks of Hydroxychloroquine Treatment in Patients With Systemic Lupus Erythematosus
Authors' conclusion
For patients with SLE, higher-dose HCQ improves effectiveness, with reduced risks of CAD and VTE. There was no dose-related difference in the risk of HCQ retinopathy for patients with SLE aged younger than 45 years.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) aged over 10 years initiating hydroxychloroquine (HCQ), without other systemic autoimmune disease at baseline or historical outcomes of interest; Taiwan's National Health Insurance Research Database, 2010–2021mean follow-up of six years
- Participants
- 878 vs 22,405
- Exposure
- Higher-dose HCQ vs lower-dose HCQ
- Higher-dose HCQn = 878
- Lower-dose HCQn = 22,405reference
- Outcome
- Coronary artery disease (CAD), ischemic stroke, venous thromboembolism (VTE), end-stage renal disease, malignancy and HCQ retinopathy
Methodological detailsnationwide, inverse probability weighting
- Nationwide
- Inverse probability weighting
Main finding
As reported in the abstract
Each group vs lower-dose HCQEstimate (95% CI)
Higher-dose HCQ
HR (CAD) 0.86(0.80–0.93)
Higher-dose HCQ
HR (VTE) 0.40(0.33–0.49)
Observational data: associations, not effects.
Safety
| Outcome | HR (patients with SLE aged over 45 years) (95% CI) | |
|---|---|---|
| HCQ retinopathy · mean follow-up of six years | 1.87 (1.45–2.42) | |
| 0.512Hazard ratio (patients with SLE aged over 45 years) (log scale) |
HCQ retinopathy · mean follow-up of six years
- No dose-related difference in HCQ retinopathy overall, except among patients aged over 45 years
Original publication
Weighing Dose‐Related Benefits and Risks of Hydroxychloroquine Treatment in Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. Published 17 February 2026. doi:10.
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