Journal article
Retinal toxicity in a multinational inception cohort of patients with systemic lupus on hydroxychloroquine
Lupus science & medicine, v 9(1), 000789
17 Nov 2022
PMID: 36396267
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectiveTo evaluate hydroxychloroquine (HCQ)-related retinal toxicity in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.MethodsData were collected at annual study visits between 1999 and 2019. We followed patients with incident SLE from first visit on HCQ (time zero) up to time of retinal toxicity (outcome), death, loss-to-follow-up or end of study. Potential retinal toxicity was identified from SLICC Damage Index scores; cases were confirmed with chart review. Using cumulative HCQ duration as the time axis, we constructed univariate Cox regression models to assess if covariates (ie, HCQ daily dose/kg, sex, race/ethnicity, age at SLE onset, education, body mass index, renal damage, chloroquine use) were associated with HCQ-related retinal toxicity.ResultsWe studied 1460 patients (89% female, 52% white). Retinal toxicity was confirmed in 11 patients (incidence 1.0 per 1000 person-years, 0.8% overall). Average cumulative time on HCQ in those with retinal toxicity was 7.4 (SD 3.2) years; the first case was detected 4 years after HCQ initiation. Risk of retinal toxicity was numerically higher in older patients at SLE diagnosis (univariate HR 1.05, 95% CI 1.01 to 1.09).ConclusionsThis is the first assessment of HCQ and retinal disease in incident SLE. We did not see any cases of retinopathy within the first 4 years of HCQ. Cumulative HCQ may be associated with increased risk. Ophthalmology monitoring (and formal assessment of cases of potential toxicity, by a retinal specialist) remains important, especially in patients on HCQ for 10+ years, those needing higher doses and those of older age at SLE diagnosis.
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Details
- Title
- Retinal toxicity in a multinational inception cohort of patients with systemic lupus on hydroxychloroquine
- Creators
- Celline C Almeida-Brasil - McGill University Health CentreJohn G Hanly - Dalhousie UniversityMurray Urowitz - University of TorontoAnn Elaine Clarke - University of CalgaryGuillermo Ruiz-Irastorza - Autoimmune TechnologiesCaroline Gordon - University of BirminghamRosalind Ramsey-Goldman - Northwestern UniversityMichelle A Petri - Johns Hopkins MedicineEllen M Ginzler - SUNY Downstate Health Sciences UniversityDaniel J Wallace - Cedars-Sinai Medical CenterSang-Cheol Bae - Hanyang University Seoul HospitalJuanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMary-Anne Dooley - University of North Carolina at Chapel HillChristine Peschken - University of ManitobaDavid Isenberg - University College LondonAnisur Rahman - University College LondonSusan Manzi - Allegheny Health NetworkSøren Jacobsen - Copenhagen University HospitalS Sam Lim - Emory UniversityRonald van Vollenhoven - Center for RheumatologyOla Nived - Lund UniversityAndreas Jönsen - Lund UniversityDiane L Kamen - Medical University of South CarolinaCynthia Aranow - Feinstein Institute for Medical ResearchJorge Sánchez-Guerrero - Toronto Western HospitalDafna D Gladman - Toronto Western HospitalPaul R Fortin - Université LavalGraciela S Alarcon - University of Alabama at BirminghamJoan T Merrill - Oklahoma Medical Research FoundationKenneth Kalunian - University of California, San DiegoManuel Ramos-Casals - Universitat de BarcelonaKristjan Steinsson - National University Hospital of IcelandA Zoma - Hairmyres HospitalAnca D Askanase - Columbia University Irving Medical CenterMunther Khamashta - St Thomas' HospitalIan N Bruce - MRC Epidemiology UnitMurat Inanc - Istanbul UniversityLuck Lukusa - McGill University Health CentreSasha Bernatsky - McGill University Health Centre
- Publication Details
- Lupus science & medicine, v 9(1), 000789
- Publisher
- Lupus Foundation of America
- Grant note
- Arthritis Research UK (http://dx.doi.org/10.13039/501100000341) M01 RR000046; UL1 RR025741 / National Center for Research Resources (http://dx.doi.org/10.13039/100000097) P60 AR048098; P60 AR064464; R01 AR043727; R01 AR069572 / National Institute of Arthritis and Musculoskeletal and Skin Diseases (http://dx.doi.org/10.13039/100000069) U01DP005119 / ACL/ACL HHS PJT-156395 / CAPMC UL1 TR000150; UL1 TR001422 / National Center for Advancing Translational Sciences (http://dx.doi.org/10.13039/100006108) Wellcome Trust (http://dx.doi.org/10.13039/100010269) DH / Department of Health United Kingdom
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000890215100001
- Scopus ID
- 2-s2.0-85143398652
- Other Identifier
- 991021934000604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology