{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:00:33Z","timestamp":1783702833199,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"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":["K23\u2010AR\u201007904"],"award-info":[{"award-number":["K23\u2010AR\u201007904"]}],"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":["K24\u2010AR\u2010066109"],"award-info":[{"award-number":["K24\u2010AR\u2010066109"]}],"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":["P30\u2010AR\u2010072577"],"award-info":[{"award-number":["P30\u2010AR\u2010072577"]}],"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":["P50\u2010AR\u2010060772"],"award-info":[{"award-number":["P50\u2010AR\u2010060772"]}],"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":["R01\u2010AR\u2010065944"],"award-info":[{"award-number":["R01\u2010AR\u2010065944"]}],"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":["T32\u2010AR\u2010007258"],"award-info":[{"award-number":["T32\u2010AR\u2010007258"]}],"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":[[2024,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to determine the impact of hydroxychloroquine (HCQ) dose on the risk of hospitalizations for systemic lupus erythematosus (SLE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a case\u2010crossover study within an academic health system, including patients with SLE who used HCQ and had \u22651 hospitalization for active SLE between January 2011 and December 2021. Case periods ended in hospitalization for SLE, whereas control periods did not. The exposures were the average weight\u2010based HCQ dose, categorized as \u22645 or &gt;5 mg\/kg\/day, and non\u2013weight\u2010based HCQ dose, categorized as &lt;400 or 400 mg\/day, assessed during each six\u2010month case or control period. Odds ratios (ORs) were calculated using conditional logistic regression and adjusted for prior disease activity, kidney function, glucocorticoid use, and other immunosuppressant use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2,974 patients with SLE who used HCQ (mean age 36.5 years; 92% female), 584 had \u22651 hospitalization with primary discharge diagnosis of SLE. Of these, 122 had \u22651 hospitalization for active SLE while using HCQ and had \u22651 control period with HCQ use during the study period. Lower HCQ weight\u2010based dose (\u22645 vs &gt;5 mg\/kg\/day) and non\u2013weight\u2010based dose (&lt;400 vs 400 mg\/day) were each associated with increased hospitalizations for active SLE (adjusted OR 4.20, 95% confidence interval [CI] 1.45\u201312.19, and adjusted OR 3.39, 95% CI 1.31\u20138.81).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of lower doses of HCQ was associated with an increased risk of hospitalizations for active SLE. Although the long\u2010term risk of HCQ retinopathy must be acknowledged, this must be balanced with the short\u2010term and cumulative risks of increased SLE activity.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art42924-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42924","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T01:58:16Z","timestamp":1717466296000},"page":"1512-1517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Hydroxychloroquine Dose and Hospitalizations for Active Lupus"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-5476","authenticated-orcid":false,"given":"Jacquelyn","family":"Nestor","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon","family":"Choi","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mancini","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baijun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-0888","authenticated-orcid":false,"given":"Yuqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-9388","authenticated-orcid":false,"given":"Karen H.","family":"Costenbader","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-880X","authenticated-orcid":false,"given":"April","family":"Jorge","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24356"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203306071872"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.106"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199101173240303"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22-2453"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2014.3459"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0111-8"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.11.017"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.01.058"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215089"},{"key":"e_1_2_6_12_1","unstructured":"Rheumatology ACo.Qualified Clinical Data Registry (QCDR). 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