{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:44:39Z","timestamp":1780533879239,"version":"3.54.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T00:00:00Z","timestamp":1741996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>: Recent systemic lupus erythematosus (SLE) guidelines recommend using hydroxychloroquine (HCQ) at &amp;lt;5.0\u2009mg\/kg\/day to reduce retinopathy risk but note that doses below this may increase flare risk, suggesting 5.0\u2009mg\/kg\/day as ideal. Evidence is insufficient, especially among the Japanese.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>: We retrospectively analysed 321 SLE patients treated with HCQ at Juntendo University Hospital between December 2015 and March 2019. They were divided into a low-dose group (&amp;lt;5\u2009mg\/kg\/day, n\u2009=\u2009205) and a high-dose group (\u22655\u2009mg\/kg\/day, n\u2009=\u2009116). This study compared side effect discontinuation rates, flare rates, and treatment efficacy in Japanese SLE patients according to HCQ dosage, evaluating changes in Systemic Lupus Erythematosus Disease Activity Index, glucocorticoid dosage, complement activity, and anti-ds DNA antibody titer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>: Three hundred and twenty-one patients were followed for a median of 66\u2009months. The side effect discontinuation rate was not significantly different. SLE flare rates were 5.4% in the low-dose group and 8.6% in the high-dose group, with no significant difference (P\u2009=\u2009.170). While the high-dose group showed a trend towards better treatment efficacy for secondary outcomes, the differences were not statistically significant.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>: There was no significant difference in flare incidence based on HCQ dosage. In the maintenance phase of remission, a lower dosage may be sufficient.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mr\/roaf025","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T05:47:21Z","timestamp":1742017641000},"page":"843-849","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of the appropriate dose of hydroxychloroquine in systemic lupus erythematosus in Japan"],"prefix":"10.1093","volume":"35","author":[{"given":"Eitaro","family":"Yoshida","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-2297","authenticated-orcid":false,"given":"Kentaro","family":"Minowa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yanagimoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Nishi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Makiyama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Yamaji","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,15]]},"reference":[{"key":"2025090306271880100_R1","doi-asserted-by":"crossref","DOI":"10.1136\/ard-2023-224762","article-title":"EULAR recommendations for the management of systemic lupus erythematosus: 2023 update","volume":"83","author":"Fanouriakis","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"2025090306271880100_R2","article-title":"A randomized study of the effect of withdrawing hydroxychloroquine sulfate in systemic lupus erythematosus","volume":"324","author":"Canadian Hydroxychloroquine Study Group","year":"1991","journal-title":"N Engl J Med"},{"key":"2025090306271880100_R3","doi-asserted-by":"crossref","DOI":"10.1016\/j.lpm.2014.03.007","article-title":"Hydroxychloroquine: a multifaceted treatment in lupus","volume":"43","author":"Costedoat-Chalumeau","year":"2014","journal-title":"Presse Med"},{"key":"2025090306271880100_R4","doi-asserted-by":"crossref","DOI":"10.1002\/art.21039","article-title":"Systemic lupus erythematosus in three ethnic groups: XVI. 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