Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort

Arthritis Rheumatol. 2023; 75(12):2195–2206 DOI: 10.1002/art.42645

In this study, severe nonadherence to hydroxychloroquine (HCQ) was independently associated with the risk of SLE flare in the following year, early damage and 5-year mortality. The serum of 660 patients prescribed HCQ for at least 3 months at enrollment in the SLICC Inception Cohort were analysed, and severe nonadherence defined by a serum HCQ level <106 ng/mL or <53 ng/mL for HCQ doses of 400 or 200 mg/day, respectively. HCQ serum levels, risks of SLE flares, damage, and mortality rates over 5 years of follow-up were objectively assessed.