CHICAGO—As good an option as hydroxychloroquine (HCQ) is for many patients with rheumatic diseases, such as rheumatoid arthritis and especially lupus, safety must be an important consideration, an expert said at this April’s ACR State-of-the-Art Clinical Symposium.
Explore this issueJune 2018
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The use of the antimalarial has become a controversial subject, with clinicians trying to balance the drug’s disease-modifying effects with concerns about toxicity to the retina that can impair vision in patients on high and long-term doses. Some rheumatologists worry recommendations issued in 2016 by the American Academy of Ophthalmology (AAO) call for too much caution, possibly at the expense of treatment efficacy.
James Rosenbaum, MD, wears both hats: He’s chair of arthritis and rheumatic diseases at Oregon Health & Science University, and chief of ophthalmology at Legacy Devers Eye Institute in Portland, Ore. In his talk, he said the safety concerns are not meant to curb use of HCQ. He held out acetaminophen as an example: It’s a great drug, but it’s also the top cause of liver toxicity in the U.S., so its use shouldn’t go unchecked.