Patients with systemic lupus erythematosus (SLE) who are treated with lower doses of hydroxychloroquine
(HCQ) have an increased risk for hospitalization for SLE flares, according to a study presented at the 2022 annual meeting of the American College of Rheumatology. In a case-crossover study, Jacquelyn Nestor, MD, PhD, and colleagues assessed this association in 2,971 patients with SLE who used HCQ during 2011-2021. Case periods were defined as 6 months prior to an SLE hospitalization, while control periods were defined as
non-overlapping 6-month periods without an SLE hospitalization. A total of 576 patients had at least
one hospitalization with a primary discharge diagnosis of SLE, among whom 108 were hospitalized for an SLE flare while using HCQ and had one or more control periods with HCQ use during the study period. Both weight-based, low-dose HCQ (≤5 vs 5 mg/kg/day) and non-weight-based, low dose HCQ (<400 vs 400 mg/day) were associated with increased hospitalizations for SLE (adjusted ORs, 4.41 and 3.48, respectively).