{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:15:50Z","timestamp":1793081750573,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T00:00:00Z","timestamp":1619913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR069572"],"award-info":[{"award-number":["R01 AR069572"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["T32AR048522"],"award-info":[{"award-number":["T32AR048522"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Hydroxychloroquine (HCQ) has a primary role in the prophylaxis and treatment of systemic lupus erythematosus (SLE) and may be protective against thrombosis in SLE. Optimal weight\u2010based dosing of HCQ is unknown. This study was undertaken to examine the usefulness of HCQ blood monitoring in predicting thrombosis risk in a longitudinal SLE cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      HCQ levels were serially quantified from EDTA whole blood by liquid chromatography\u2013tandem mass spectrometry. The mean HCQ blood levels calculated prior to thrombosis or until the last visit were compared using\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests between patients with and those without thrombosis. Pooled logistic regression was used to analyze the association between rates of thrombosis and HCQ blood level. Rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 739 patients with SLE, thrombosis occurred in 38 patients (5.1%). The mean \u00b1 SD HCQ blood level was lower in patients who developed thrombosis versus those who did not develop thrombosis (720 \u00b1 489 ng\/ml versus 935 \u00b1 580 ng\/ml;\n                      <jats:italic>P =<\/jats:italic>\n                      0.025). Thrombosis rates were reduced by 13% for every 200\u2010ng\/ml increase in the most recent HCQ blood level (RR 0.87 [95% CI 0.78\u20130.98],\n                      <jats:italic>P =<\/jats:italic>\n                      0.025) and by 13% for mean HCQ blood level (RR 0.87 [95% CI 0.76\u20131.00],\n                      <jats:italic>P =<\/jats:italic>\n                      0.056). Thrombotic events were reduced by 69% in patients with mean HCQ blood levels \u22651,068 ng\/ml versus those with levels &lt;648 ng\/ml (RR 0.31 [95% CI 0.11\u20130.86],\n                      <jats:italic>P =<\/jats:italic>\n                      0.024). This remained significant after adjustment for confounders (RR 0.34 [95% CI 0.12\u20130.94],\n                      <jats:italic>P =<\/jats:italic>\n                      0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low HCQ blood levels are associated with thrombotic events in SLE. Longitudinal measurement of HCQ levels may allow for personalized HCQ dosing strategies. Recommendations for empirical dose reduction may reduce or eliminate the benefits of HCQ in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.41621","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T19:01:13Z","timestamp":1609959673000},"page":"997-1004","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Association of Higher Hydroxychloroquine Blood Levels With Reduced Thrombosis Risk in Systemic Lupus Erythematosus"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-5373","authenticated-orcid":false,"given":"Michelle","family":"Petri","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5045-5255","authenticated-orcid":false,"given":"Maximilian 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