SLE- HCQ DI

Question 1

HCQ drug class

Answer 1

Antimalarial (but also a DMARD)

Question 2

HCQ dosing for suppression

Answer 2

400mg PO QD-BID

Question 3

HCQ dosing for maintenance

Answer 3

200-400mg PO QD

Question 4

HCQ ADEs

Answer 4

Flu-life symptoms
Ocular toxicity
Allergic skin eruptions
Skin and hair pigmentation changes
Hematological changes
GI upset
Myopathies/palsies/CNS
Cardiomyopathy
Hearing loss

Question 5

Risk factors for HCQ ocular toxicity

Answer 5

Dose, length of therapy, CKD, previous retinal or macular disease

Question 6

HCQ ocular toxicity risk is lower with what?

Answer 6

Daily dose is <5mg/kg ABW

Question 7

Hematological changes with HCQ

Answer 7

Agranulocytosis, neutropenia, aplastic anemia, thrombocytopenia, pancytopenia

Question 8

HCQ monitoring

Answer 8

Eye exam at baseline, 5 years out, then every year after

Question 9

When to use HCQ

Answer 9

Long-term management of SLE and DLE

Question 10

What kinds of patients can you use HCQ in?

Answer 10

ALL SLE patients unless it’s CI’ed

Question 11

Onset of action of HCQ

Answer 11

2-4 months

Question 12

While HCQ takes 2-4 months to work, what can you use in the meantime to control symptoms?

Answer 12

NSAIDs

Question 13

Adequate trial of HCQ

Answer 13

6 months

Question 14

HCQ and pregnancy

Answer 14

Good outcomes in pregnant women- D/C’ing it will increase flare risk and increase morbidity and mortality risk in the fetus

Question 15

Benefits of HCQ

Answer 15

Decreases skin rashes, major organ involvement, mortality, and neuropsychiatric reactions