Prevalence and risk factors for chloroquine maculopathy and role of plasma chloroquine and desethylchloroquine concentrations in predicting chloroquine maculopathy
Article first published online: 18 JAN 2013
© 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd
International Journal of Rheumatic Diseases
Volume 16, Issue 1, pages 47–55, February 2013
How to Cite
Chiowchanwisawakit, P., Nilganuwong, S., Srinonprasert, V., Boonprasert, R., Chandranipapongse, W., Chatsiricharoenkul, S., Katchamart, W., Pongnarin, P., Danwiriyakul, W., Koolvisoot, A., Arromdee, E. and Ruangvaravate, N. (2013), Prevalence and risk factors for chloroquine maculopathy and role of plasma chloroquine and desethylchloroquine concentrations in predicting chloroquine maculopathy. International Journal of Rheumatic Diseases, 16: 47–55. doi: 10.1111/1756-185X.12029
- Issue published online: 27 FEB 2013
- Article first published online: 18 JAN 2013
- Siriraj Research Development Fund. Grant Numbers: R015332001, R015232069
- chloroquine maculopathy;
- antimalarial drug;
- risk factors;
- plasma chloroquine levels;
- plasma desethylchloroquine levels;
- Humphrey visual field
To determine the prevalence and to identify the risk factors of chloroquine maculopathy (CM), and to evaluate the association of plasma chloroquine (CQ) and desethylchloroquine (DCQ) levels and CM.
Rheumatoid arthritis (RA) patients who had taken CQ for at least 6 months and stable CQ dosage for at least 2 months were included. CM was diagnosed by dilated ocular examination and automated visual field. Plasma CQ and DCQ levels were determined by liquid chromatography tandem mass spectrometry method. Logistic regression was used to explore risk factors associated with CM.
One hundred and ninety-three patients were included with median CQ duration (range) of 50.2 months (6.0–269.8) and cumulative dose of 137.4 g (16.4–1226.5). The prevalence of CM was 13.5%. Factors associated with CM identified from univariate analysis were age > 60 years, and creatinine clearance with odds ratio (OR) (95%CI) of 5.79 (2.42, 13.84), and 0.98 (0.96, 1.00). In multivariate analysis, older age, usage > 5 years, and current dose from 2.5 mg/kg ideal body weight [IBW]/day were the factors significantly associated with CM with OR of 5.89 (2.38, 14.57), 2.94 (1.10, 7.83), and 3.32 (1.04, 10.60), respectively, while plasma CQ and DCQ showed no association with CM.
The prevalence of CM was 13.5% among RA patients taking CQ for at least 6 months. Age > 60 years, duration of CQ usage > 5 years and current CQ dose ≥2.5 mg/kg IBW/day were the risk factors for CM. The plasma CQ or DCQ levels demonstrated no correlation in developing CM.