Is Hydroxychloroquine As Effective As Phlebotomy for Porphyria Cutanea Tarda?

Porphyria cutanea tarda (PCT) is an iron-related disorder that results from reduced activity of hepatic uroporphyrinogen decarboxylase. Treatment options include phlebotomy or low doses of hydroxychloroquine. Phlebotomy is expensive, inconvenient, and can increase risk for anemia or syncope. Alternately, hydroxychloroquine is inexpensive and its oral dosing convenient, but it should be avoided in patients with hepatic and renal dysfunction. Few studies have compared the efficacy and safety of these two treatment options.

In an unblinded, prospective trial, patients who fulfilled standard diagnostic criteria for PCT received either 100 mg of oral hydroxychloroquine twice weekly or phlebotomy every 2 weeks. Phlebotomy was postponed if a patien…