Low blood concentration of hydroxychloroquine in patients with refractory cutaneous lupus erythematosus: a French multicenter prospective study.

To study the relation between blood concentration of hydroxychloroquine and the clinical efficacy of hydroxychloroquine sulfate in a series of patients with cutaneous lupus erythematosus (CLE).
Prospective multicenter study. A staff dermatologist blinded to blood hydroxychloroquine concentrations performed a standardized review of medical records and assessment of hydroxychloroquine efficacy in the following 3 categories: complete remission, partial remission (clearing of >50% of skin lesions), or treatment failure. Whole-blood samples were collected for measurement of blood hydroxychloroquine concentration.
Fourteen French university hospitals.
Three hundred consecutive patients with subacute or chronic CLE who had been treated with hydroxychloroquine for at least 3 months.
The statistical significance of correlation between blood hydroxychloroquine concentration and efficacy of hydroxychloroquine and the statistical associations in univariate and multivariate analyses of complete remission with several variables.
The study included 300 patients with discoid lupus erythematosus (n = 160), subacute CLE (n = 86), lupus erythematosus tumidus (n = 52), chilblain lupus (n = 26), and lupus panniculitis (n = 16); 38 of these patients had 2 or more associated forms. Median blood hydroxychloroquine concentration was significantly higher in patients with complete remission (910 [range, <50 to 3057] ng/mL) compared with partial remission (692 [<50 to 2843] ng/mL) and treatment failure (569 [<50 to 2242] ng/mL) (P = .007). In the multivariate analysis, complete remission was associated with higher blood hydroxychloroquine concentrations (P = .005) and the absence of discoid lesions (P = .004). Thirty patients (10.0%) had very low blood hydroxychloroquine concentrations (<200 ng/mL) and may be considered nonadherent to the treatment regimen.
Monitoring hydroxychloroquine blood concentrations might improve the management of refractory CLE.
AuthorsCamille Francès, Anne Cosnes, Pierre Duhaut, Noël Zahr, Boutros Soutou, Saskia Ingen-Housz-Oro, Didier Bessis, Jacqueline Chevrant-Breton, Nadège Cordel, Dan Lipsker, Nathalie Costedoat-Chalumeau
JournalArchives of dermatology (Arch Dermatol) Vol. 148 Issue 4 Pg. 479-84 (Apr 2012) ISSN: 1538-3652 [Electronic] United States
PMID22508872 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimalarials
  • Hydroxychloroquine
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimalarials (blood, therapeutic use)
  • Chilblains (drug therapy)
  • Child
  • Female
  • France
  • Humans
  • Hydroxychloroquine (blood, therapeutic use)
  • Lupus Erythematosus, Cutaneous (drug therapy)
  • Male
  • Medication Adherence
  • Middle Aged
  • Multivariate Analysis
  • Panniculitis, Lupus Erythematosus (drug therapy)
  • Prospective Studies
  • Single-Blind Method
  • Statistics, Nonparametric
  • Treatment Outcome
  • Young Adult

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: