Because Dr. Yelin is Co-Editor of Arthritis Care & Research, review of this article was handled by the Editor of Arthritis & Rheumatism.
Systemic Lupus Erythematosus
Hydroxychloroquine treatment in a community-based cohort of patients with systemic lupus erythematosus
Article first published online: 25 FEB 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 3, pages 386–392, March 2010
How to Cite
Schmajuk, G., Yazdany, J., Trupin, L. and Yelin, E. (2010), Hydroxychloroquine treatment in a community-based cohort of patients with systemic lupus erythematosus. Arthritis Care Res, 62: 386–392. doi: 10.1002/acr.20002
- Issue published online: 25 FEB 2010
- Article first published online: 25 FEB 2010
- Manuscript Accepted: 9 NOV 2009
- Manuscript Received: 4 AUG 2009
- American College of Rheumatology Research and Education Foundation Physician-Scientist Development Award
- National Center for Research Resources. Grant Number: 5-M01-RR-00079
- Rosalind Russell Medical Research Center for Arthritis, NIH. Grant Number: R01-AR-44804
- State of California Lupus Fund
- Arthritis Foundation
- Agency for Healthcare Research and Quality
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Numbers: 1-R01-HS-013893, P60-AR-053308
In recent years hydroxychloroquine (HCQ) has emerged as a key therapy in systemic lupus erythematosus (SLE). We determined the rates of HCQ use in a diverse, community-based cohort of patients with SLE and identified predictors of current HCQ use.
Patients were participants in the University of California San Francisco Lupus Outcomes Study, an ongoing longitudinal study of patients with confirmed SLE. We examined the prevalence of HCQ use per person-year and compared baseline characteristics of users and nonusers, including demographic, socioeconomic, clinical, and health system use variables. Multiple logistic regression with generalized estimating equations was used to evaluate predictors of HCQ use.
A total of 881 patients contributed 3,095 person-years of data over 4 interview cycles. The prevalence of HCQ use was 55 per 100 person-years and was constant throughout the observation period. In multivariate models, the odds of HCQ use were nearly doubled among patients receiving their SLE care from a rheumatologist compared with those identifying generalists or nephrologists as their primary sources of SLE care. In addition, patients with shorter disease duration were more likely to use HCQ, even after adjusting for age and other covariates.
In this community-based cohort of patients, HCQ use was suboptimal. Physician specialty and disease duration were the strongest predictors of HCQ use. Patients who are not using HCQ, those with longer disease duration, and those who see nonrheumatologists for their SLE care should be targeted for quality improvement.