Research Supports Measuring Blood for Hydroxychloroquine Levels to Assess Medication Adherence in People with Lupus
Hydroxychloroquine (Plaquenil®) is the most prescribed medication in the treatment of lupus and has numerous benefits including prevention of flares, prolonged survival, and other positive outcomes. Medication non-adherence is reported in up to 80% of people with lupus and is associated with reduced health outcomes.
A new study evaluated the role of measuring hydroxychloroquine (HCQ) blood levels to assess if lower levels of HCQ were associated with higher disease activity. The study enrolled 108 people who were then treated with HCQ for at least 6 months. The study enrolled mainly Hispanic (63%) and African American (19%) women with lupus.
The results show that 41% of participants had low blood HCQ levels, consistent with non-adherence; 19% of these had undetectable levels. Of the non-adherent participants, 91% were female, with a predominance of Hispanics (68%) and African Americans (21%). Participants with high HCQ levels (adherent) were predominantly female and more likely to be Caucasian. Low HCQ levels were associated with higher lupus disease activity scores, with many also diagnosed with depression.
The researchers conclude that measuring HCQ blood levels is a simple and reliable method to evaluate medication adherence in lupus and more work to address non-adherence is needed.
Research from the Lupus Foundation of America underscored the need for further exploration on cultural factors negatively influencing treatment adherence among certain racial groups, and is working to increase racial representation in lupus clinical trials.