Older People with Lupus Do Not Have Increased Risk of Flares when Discontinuing Hydroxychloroquine Treatment
Older adults (age 55+) do not experience a significant increase in disease activity (flares) if they discontinue hydroxychloroquine (HCQ) treatment when disease activity is stable.
Researchers examined the multicenter records of 26 older persons with lupus who discontinued HCQ use. The outcomes of five people who withdrew from HCQ were compared to five people who continued taking the therapy. No severe flares occurred within either group during the 12 months following HCQ discontinuation or continuation. The HCQ withdrawal group experienced lower (7.7%) moderate flares than the group of persons that continued taking the therapy (15.6%).
Study author, Dr. Ruth Fernandez-Ruiz notes, “In lupus patients 55 years or older with quiescent [calm] disease and taking hydroxychloroquine for over 5 years, discontinuation or maintenance of medication resulted in similar overall flare rates of 19% versus 16%, respectively, during one year of follow up.”
Retinal toxicity (42.3%), patient preference (34.6%), other or confirmed suspected adverse effects (15/4%), ophthalmologist recommendation for macular degeneration (3.8%) and rheumatologist recommendation for low disease activity (3.8%) were the most common reasons for discontinuing HCQ treatment.
Dr. Fernandez-Ruiz adds, "Older patients with lupus on long term hydroxychloroquine may be at significant risk for adverse events such as maculopathy. This early study provided reassuring results regarding the safety of discontinuing this medication in quiescent lupus patients. Specifically, the rates of lupus flares in patients 55 years or older who had been taking hydroxychloroquine for over 5 years were similar for patients who discontinued or remained on the medication. Larger prospective studies are needed to confirm these encouraging observations."
Before making any changes to medications, please consult with your doctor. Learn about hydroxychloroquine benefits, side effects and dosing.