Hydroxychloroquine blood levels predicts flare in childhood-onset lupus nephritis
Hydroxychloroquine blood levels predicts flare in childhood-onset lupus nephritis
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DOI：
10.1177/09612033211062515
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发表时间：
2021-12-29
期刊：
影响因子：
2.6
通讯作者：
Aikawa, Nadia Emi
中科院分区：
文献类型：
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作者：
Balbi, Verena Andrade;Silva, Clovis Artur;Aikawa, Nadia Emi
目的 低羟氯喹 (HCQ) 血液水平是成人狼疮发作的预测因子。儿童期发病的系统性红斑狼疮 (cSLE) 发病率很高，高达 80% 的病例累及肾脏。本研究的目的是确定预测儿童期狼疮性肾炎 (LN) 发作的 HCQ 截止水平。方法 对 60 名使用 HCQ 至少 6 个月的 LN 患者在基线 (BL) 和约 6 个月后进行前瞻性评估，评估其 cSLE 发作情况以及通过液相色谱-串联质谱法测量的 HCQ 血液水平 (ng/mL)。结果 研究期间，有 19 名患者 (32%) 出现耀斑，中位 SLEDAI 增加 4 (0-8)。与稳定患者相比，发作组的中位 (IQR) BL HCQ 水平较低 [557.5 (68.6-980.3) vs. 1061.9 (534.8-1590.0 ng/mL)； p=0.012]。 ROC 曲线分析表明 HCQ 水平
Objective Low hydroxychloroquine (HCQ) blood levels are predictors of flare in adult lupus. Childhood-onset systemic lupus erythematosus (cSLE) has high morbidity with renal involvement in up to 80% of cases. The aim of this study is to determine the HCQ cut-off levels which predicts flare in childhood-onset lupus nephritis (LN). Methods Sixty LN patients on HCQ use for at least 6-months were prospectively evaluated at baseline (BL) and about 6-months later for cSLE flare and HCQ blood levels (ng/mL) measured by liquid chromatography-tandem mass spectrometry. Results There were 19 patients (32%) with flare, during the study with median SLEDAI increase of 4 (0-8). Median (IQR) BL HCQ levels of the flare group were lower compared to stable patients [557.5 (68.6-980.3) vs. 1061.9 (534.8-1590.0 ng/mL); p=0.012]. ROC curve analysis demonstrated that HCQ levels