{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:49:10Z","timestamp":1759452550813,"version":"build-2065373602"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01\u2010AR\u2010069572"],"award-info":[{"award-number":["R01\u2010AR\u2010069572"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01\u2010DK\u2010134625"],"award-info":[{"award-number":["R01\u2010DK\u2010134625"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Having a low complement level is associated with clinical systemic lupus erythematosus (SLE) disease activity and future organ damage. We studied the association of hydroxychloroquine (HCQ) whole blood levels with changes in complement level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed two analyses on data prospectively collected from an SLE cohort. In the first (a \u201cnew starts on HCQ\u201d analysis), we compared changes in complement level between those starting HCQ and those not starting it.\u00a0The second analysis evaluated the association between HCQ whole blood levels and low complement level in all cohort visits using conditional logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the \u201cnew starts on HCQ\u201d analysis, a higher percentage of patients starting HCQ (as reflected in HCQ blood levels &gt;50) experienced a normalization of C4 level compared to those not starting HCQ (23 of 57 [40%] vs. 9 of 56 [13%]; <jats:italic>P<\/jats:italic> = 0.011), as well as a significantly greater increase in both C3 and C4 level (<jats:italic>P<\/jats:italic> = 0.048 and <jats:italic>P<\/jats:italic> = 0.017, respectively). In the \u201call cohort visits\u201d analysis, there was a statistically significant higher probability of having normal C4 levels in visits with higher HCQ whole blood levels (odds ratio 1.8\u20132.6 depending on the levels). This relationship was most pronounced for whole blood HCQ levels of 200 ng\/mL or more.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We observed significant improvement in complement levels when HCQ was started and among those with higher whole blood levels of HCQ, particularly with respect to C4. Modulating the pathogenic mechanisms that lead to complement consumption may be one mode by which HCQ prevents poor outcomes in SLE.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25381","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T01:58:12Z","timestamp":1717466292000},"page":"1396-1399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hydroxychloroquine Improves Low Complement Levels"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9411-7753","authenticated-orcid":false,"given":"Rebecca","family":"Jacobson","sequence":"first","affiliation":[{"name":"University of California  Irvine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5003-3503","authenticated-orcid":false,"given":"Daniel","family":"Goldman","sequence":"additional","affiliation":[{"name":"Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6738-4836","authenticated-orcid":false,"given":"Andrea","family":"Fava","sequence":"additional","affiliation":[{"name":"Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Magder","sequence":"additional","affiliation":[{"name":"University of Maryland  Baltimore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-5373","authenticated-orcid":false,"given":"Michelle","family":"Petri","sequence":"additional","affiliation":[{"name":"Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200110)44:10<2350::AID-ART398>3.0.CO;2-A"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34672"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2019-000346"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.191094"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009749609069986"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201089"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.4317-19"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.5042-20"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13792"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-12_Part_1-200506210-00004"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-3252-8_19"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24155"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25228"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41621"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110848"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9861(63)80021-1"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090019"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2017.1269168"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.25381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:27:06Z","timestamp":1759422426000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.25381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,2]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/acr.25381"],"URL":"https:\/\/doi.org\/10.1002\/acr.25381","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"type":"print","value":"2151-464X"},{"type":"electronic","value":"2151-4658"}],"subject":[],"published":{"date-parts":[[2024,7,2]]},"assertion":[{"value":"2024-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}