How Safe Is Long-Term Hydroxychloroquine?

Longer duration and higher dose were among factors that raised risk for toxic retinopathy.

Hydroxychloroquine is often prescribed as long-term therapy for many dermatologic indications, and it may have broader benefits (e.g., preventing or improving thrombophilia associated with lupus erythematosus, neonatal lupus erythematosus, diabetes in rheumatoid arthritis and other connective tissue diseases, and as adjunctive therapy in some cancers). However, its use is associated with risk for toxic retinopathy.

Guidelines for monitoring for ocular toxicity, including ophthalmologic examination, are seldom and sporadically followed. Reviewing records of 3.4 million persons from an integrated health system, these authors identified 2361 with continuous hydroxychloroquine use of at least 5 years who were evaluated with visual field testing …

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)