The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study
Identifieur interne : 000239 ( Hal/Curation ); précédent : 000238; suivant : 000240The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study
Auteurs : François Chasset [France] ; Laurent Arnaud [France] ; Nathalie Costedoat-Chalumeau [France] ; Noël Zahr [France] ; Didier Bessis [France] ; Camille Francès [France]Source :
- Journal of The American Academy of Dermatology [ 0190-9622 ] ; 2016-04.
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Abstract
BACKGROUND:Up to 30% of patients with cutaneous lupus erythematosus (CLE) fail to respond to hydroxychloroquine (HCQ).OBJECTIVES:We sought to evaluate the efficacy of increased daily doses of HCQ on cutaneous response in refractory CLE.METHODS:We conducted an open-label prospective study between 2010 and 2014. Patients with CLE and HCQ blood level less than or equal to 750 ng/mL were included. The daily dose of HCQ was increased to reach blood concentrations greater than 750 ng/mL. The primary end point was the number of responders defined by an improvement of CLE Disease Area and Severity Index score (4 points or 20% decrease) in patients with HCQ blood concentration greater than 750 ng/mL.RESULTS:We included 34 patients (26 women; median age 45 [range 28-72] years). Two nonadherent patients were excluded. The median CLE Disease Area and Severity Index score before treatment was significantly improved after treatment (8 [range 2-30] vs 1.5 [range 0-30]), P < .001). The primary response criterion was reached in 26 (81%) of the 32 patients analyzed. A decrease in HCQ doses without further CLE flare (median follow-up 15.8 [range 3.06-77.4] months) was achieved in 15 of the 26 responders.LIMITATIONS:The main limitations of the study are its open-label design and the limited number of patients included.CONCLUSIONS:Increasing HCQ doses to reach blood concentrations greater than 750 ng/mL should be considered before addition of other treatments in refractory CLE.
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DOI: 10.1016/j.jaad.2015.09.064
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Hôpitaux de Paris (AP-HP)</orgName> <orgName type="acronym">APHP</orgName> <desc> <address> <country key="FR"></country> </address> </desc> </org></tutelle><tutelle active="#struct-328304" type="direct"><org type="institution" xml:id="struct-328304" status="VALID"> <orgName>CHU Tenon [APHP]</orgName> <desc> <address> <addrLine>4 Rue de la Chine, 75020 Paris</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.aphp.fr/contenu/hopital-tenon-1</ref> </desc> </org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author></analytic><idno type="DOI">10.1016/j.jaad.2015.09.064</idno><series><title level="j">Journal of The American Academy of Dermatology</title><idno type="ISSN">0190-9622</idno><imprint><date type="datePub">2016-04</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term>antimalarials</term><term>cutaneous lupus erythematosus</term><term>hydroxychloroquine</term><term>hydroxychloroquine blood concentration</term><term>increasing dose</term><term>retinal toxicity</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"> <p>BACKGROUND:Up to 30% of patients with cutaneous lupus erythematosus (CLE) fail to respond to hydroxychloroquine (HCQ).OBJECTIVES:We sought to evaluate the efficacy of increased daily doses of HCQ on cutaneous response in refractory CLE.METHODS:We conducted an open-label prospective study between 2010 and 2014. Patients with CLE and HCQ blood level less than or equal to 750 ng/mL were included. The daily dose of HCQ was increased to reach blood concentrations greater than 750 ng/mL. The primary end point was the number of responders defined by an improvement of CLE Disease Area and Severity Index score (4 points or 20% decrease) in patients with HCQ blood concentration greater than 750 ng/mL.RESULTS:We included 34 patients (26 women; median age 45 [range 28-72] years). Two nonadherent patients were excluded. The median CLE Disease Area and Severity Index score before treatment was significantly improved after treatment (8 [range 2-30] vs 1.5 [range 0-30]), P < .001). The primary response criterion was reached in 26 (81%) of the 32 patients analyzed. A decrease in HCQ doses without further CLE flare (median follow-up 15.8 [range 3.06-77.4] months) was achieved in 15 of the 26 responders.LIMITATIONS:The main limitations of the study are its open-label design and the limited number of patients included.CONCLUSIONS:Increasing HCQ doses to reach blood concentrations greater than 750 ng/mL should be considered before addition of other treatments in refractory CLE.</p> </div></front></TEI><hal api="V3"> <titleStmt> <title xml:lang="en">The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study</title> <author role="aut"> <persName> <forename type="first">françois</forename> <surname>chasset</surname> </persName> <idno type="halauthorid">1543888</idno> <affiliation ref="#struct-223222"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Laurent</forename> <surname>Arnaud</surname> </persName> <idno type="halauthorid">127961</idno> <affiliation ref="#struct-267618"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Nathalie</forename> <surname>Costedoat-Chalumeau</surname> </persName> <idno type="halauthorid">822653</idno> <affiliation ref="#struct-189806"></affiliation> <affiliation ref="#struct-301664"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Noël</forename> <surname>Zahr</surname> </persName> <idno type="halauthorid">974099</idno> <affiliation ref="#struct-41012"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Didier</forename> <surname>Bessis</surname> </persName> <email type="md5">0f6883615e3fc3556a3c186c5b7e0750</email> <email type="domain">free.fr</email> <idno type="halauthorid">632459</idno> <affiliation ref="#struct-258773"></affiliation> <affiliation ref="#struct-139833"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Camille</forename> <surname>Francès</surname> </persName> <idno type="halauthorid">822651</idno> <affiliation ref="#struct-223222"></affiliation> </author> <editor role="depositor"> <persName> <forename>Anthony</forename> <surname>Herrada</surname> </persName> <email type="md5">22bca7b7384ac878a90553705fdc7ce0</email> <email type="domain">umontpellier.fr</email> </editor> </titleStmt> <editionStmt> <edition n="v1" type="current"> <date type="whenSubmitted">2019-01-21 15:35:55</date> <date type="whenModified">2020-03-24 16:10:29</date> <date type="whenReleased">2019-01-21 15:35:55</date> <date type="whenProduced">2016-04</date> <ref type="externalLink" target="https://dumas.ccsd.cnrs.fr/dumas-01524470/file/ThExe_CHASSET_Fran%C3%A7ois_DUMAS.pdf"></ref> </edition> <respStmt> <resp>contributor</resp> <name key="557504"> <persName> <forename>Anthony</forename> <surname>Herrada</surname> </persName> <email type="md5">22bca7b7384ac878a90553705fdc7ce0</email> <email type="domain">umontpellier.fr</email> </name> </respStmt> </editionStmt> <publicationStmt> <distributor>CCSD</distributor> <idno type="halId">hal-01988149</idno> <idno type="halUri">https://hal.umontpellier.fr/hal-01988149</idno> <idno type="halBibtex">chasset:hal-01988149</idno> <idno type="halRefHtml">Journal of The American Academy of Dermatology, Elsevier, 2016, 74 (4), pp.693-699.e3. ⟨10.1016/j.jaad.2015.09.064⟩</idno> <idno type="halRef">Journal of The American Academy of Dermatology, Elsevier, 2016, 74 (4), pp.693-699.e3. ⟨10.1016/j.jaad.2015.09.064⟩</idno> </publicationStmt> <seriesStmt> <idno type="stamp" n="UNIV-MONTPELLIER">Université de Montpellier</idno> <idno type="stamp" n="APHP" corresp="INSERM">AP-HP</idno> <idno type="stamp" n="UNIV-PARIS5">Université Paris Descartes (Paris 5)</idno> <idno type="stamp" n="IPLESP" corresp="SORBONNE-UNIVERSITE">Institut Pierre Louis d'Epidémiologie et de Santé Publique</idno> <idno type="stamp" n="BS">Biologie-Santé</idno> <idno type="stamp" n="UPMC" corresp="SORBONNE-UNIVERSITE">Université Pierre et Marie Curie</idno> <idno type="stamp" n="USPC">Université Sorbonne Paris Cité</idno> <idno type="stamp" n="UPMC_POLE_4" corresp="UPMC">UPMC Pôle 4</idno> <idno type="stamp" n="SORBONNE-UNIVERSITE">Sorbonne Université</idno> <idno type="stamp" n="SU-MEDECINE" corresp="SORBONNE-UNIVERSITE">Faculté de Médecine de Sorbonne Université</idno> <idno type="stamp" n="PCCI" corresp="UNIV-MONTPELLIER">Pathogénèse et Contrôle des Infections Chroniques</idno> </seriesStmt> <notesStmt> <note type="audience" n="2">International</note> <note type="popular" n="0">No</note> <note type="peer" n="1">Yes</note> </notesStmt> <sourceDesc> <biblStruct> <analytic> <title xml:lang="en">The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study</title> <author role="aut"> <persName> <forename type="first">françois</forename> <surname>chasset</surname> </persName> <idno type="halauthorid">1543888</idno> <affiliation ref="#struct-223222"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Laurent</forename> <surname>Arnaud</surname> </persName> <idno type="halauthorid">127961</idno> <affiliation ref="#struct-267618"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Nathalie</forename> <surname>Costedoat-Chalumeau</surname> </persName> <idno type="halauthorid">822653</idno> <affiliation ref="#struct-189806"></affiliation> <affiliation ref="#struct-301664"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Noël</forename> <surname>Zahr</surname> </persName> <idno type="halauthorid">974099</idno> <affiliation ref="#struct-41012"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Didier</forename> <surname>Bessis</surname> </persName> <email type="md5">0f6883615e3fc3556a3c186c5b7e0750</email> <email type="domain">free.fr</email> <idno type="halauthorid">632459</idno> <affiliation ref="#struct-258773"></affiliation> <affiliation ref="#struct-139833"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Camille</forename> <surname>Francès</surname> </persName> <idno type="halauthorid">822651</idno> <affiliation ref="#struct-223222"></affiliation> </author> </analytic> <monogr> <idno type="halJournalId" status="VALID">16301</idno> <idno type="issn">0190-9622</idno> <idno type="eissn">1097-6787</idno> <title level="j">Journal of The American Academy of Dermatology</title> <imprint> <publisher>Elsevier</publisher> <biblScope unit="volume">74</biblScope> <biblScope unit="issue">4</biblScope> <biblScope unit="pp">693-699.e3</biblScope> <date type="datePub">2016-04</date> </imprint> </monogr> <idno type="doi">10.1016/j.jaad.2015.09.064</idno> <idno type="pubmed">26850655</idno> </biblStruct> </sourceDesc> <profileDesc> <langUsage> <language ident="en">English</language> </langUsage> <textClass> <keywords scheme="author"> <term xml:lang="en">increasing dose</term> <term xml:lang="en">retinal toxicity</term> <term xml:lang="en">antimalarials</term> <term xml:lang="en">cutaneous lupus erythematosus</term> <term xml:lang="en">hydroxychloroquine</term> <term xml:lang="en">hydroxychloroquine blood concentration</term> </keywords> <classCode scheme="halDomain" n="sdv.mhep">Life Sciences [q-bio]/Human health and pathology</classCode> <classCode scheme="halTypology" n="ART">Journal articles</classCode> </textClass> <abstract xml:lang="en"> <p>BACKGROUND:Up to 30% of patients with cutaneous lupus erythematosus (CLE) fail to respond to hydroxychloroquine (HCQ).OBJECTIVES:We sought to evaluate the efficacy of increased daily doses of HCQ on cutaneous response in refractory CLE.METHODS:We conducted an open-label prospective study between 2010 and 2014. Patients with CLE and HCQ blood level less than or equal to 750 ng/mL were included. The daily dose of HCQ was increased to reach blood concentrations greater than 750 ng/mL. The primary end point was the number of responders defined by an improvement of CLE Disease Area and Severity Index score (4 points or 20% decrease) in patients with HCQ blood concentration greater than 750 ng/mL.RESULTS:We included 34 patients (26 women; median age 45 [range 28-72] years). Two nonadherent patients were excluded. The median CLE Disease Area and Severity Index score before treatment was significantly improved after treatment (8 [range 2-30] vs 1.5 [range 0-30]), P < .001). The primary response criterion was reached in 26 (81%) of the 32 patients analyzed. A decrease in HCQ doses without further CLE flare (median follow-up 15.8 [range 3.06-77.4] months) was achieved in 15 of the 26 responders.LIMITATIONS:The main limitations of the study are its open-label design and the limited number of patients included.CONCLUSIONS:Increasing HCQ doses to reach blood concentrations greater than 750 ng/mL should be considered before addition of other treatments in refractory CLE.</p> </abstract> </profileDesc> </hal></record>Pour manipuler ce document sous Unix (Dilib)
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