Measuring Hydroxychloroquine Blood Levels Improves Adherence

Sensitively assessing patient adherence to therapy is important in those with nonresponse; follow-up can bring improvement.

Lupus erythematosus (LE), systemic or cutaneous, is a chronic disease state requiring ongoing therapy to maintain response. Antimalarial agents are a therapeutic mainstay for patients with cutaneous LE. A previous report documented that patients with low blood levels of hydroxychloroquine (HCQ) were likely to have “failed” to respond favorably. One reason therapies fail is patient nonadherence, and blood levels are a way to measure adherence.

These authors measured HCQ blood levels at multiple time points in a subset of 628 patients in the Hopkins Lupus Cohort. The therapeutic HCQ blood level range was 500 to 2000 ng/mL. At baseline, 304 patients (44%) had subtherapeutic levels; of these, 88 (13%) were determined to be completely nonadherent…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)