Hydroxychloroquine prescription trends and predictors for excess dosing per recent ophthalmology guidelines

  • April M. Jorge (Creator)
  • Ronald B. Melles (Creator)
  • Y. Zhang (Contributor)
  • Na Lu (Creator)
  • Sharan K. Rai (Creator)
  • Lucy H.Y. Young (Creator)
  • Karen H. Costenbader (Creator)
  • Rosalind Ramsey-Goldman (Creator)
  • S. Sam Lim (Contributor)
  • John M. Esdaile (Creator)
  • Ann E. Clarke (Creator)
  • M. B. Urowitz (Contributor)
  • Anca Askanase (Creator)
  • C. Aranow (Creator)
  • Michelle A. Petri (Creator)
  • Hyon Choi (Creator)
  • Rosalind Ramsey-Goldman (Creator)
  • Michelle Petri (Creator)



Abstract Background Hydroxychloroquine (HCQ) retinopathy may be more common than previously recognized; recent ophthalmology guidelines have revised recommendations from ideal body weight (IBW)-based dosing to actual body weight (ABW)-based dosing. However, contemporary HCQ prescribing trends in the UK remain unknown. Methods We examined a UK general population database to investigate HCQ dosing between 2007 and 2016. We studied trends of excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW) and determined their independent predictors using multivariable logistic regression analyses. Results Among 20,933 new HCQ users (78% female), the proportions of initial HCQ excess dosing declined from 40% to 36% using IBW and 38% to 30% using ABW, between 2007 and 2016. Among these, 47% of women were excess-dosed (multivariable OR 12.52; 95% CI 10.99–14.26) using IBW and 38% (multivariable OR 1.98; 95% CI,1.81–2.15) using ABW. Applying IBW, 37% of normal and 44% of obese patients were excess-dosed; however, applying ABW, 53% of normal and 10% of obese patients were excess-dosed (multivariable ORs = 1.61 and 0.1 (reference = normal); both p 
Date made available2018

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