Hydroxychloroquine in patients with systemic lupus erythematosus with end-stage renal disease

Monique Bethel, Frances Margaret Yang, Shuang Li, Norris Stanley Nahman, Alyce M. Oliver, Wambui Machua, Laura D Carbone

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). Methods This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710. The prevalence, dosing, and predictors of filled HCQ prescriptions (demographic factors, dialysis type, and provider subspecialty) were determined. Results There were 10,276 patients with SLE identified; 2048 (19.9%) had a prescription for HCQ filled. The mean daily dose of HCQ was 321 mg (range 58-2000 mg). The most common daily doses were 200 (n=768, 37.5%) and 400 mg (n=1161, 56.7%). In multivariable logistic regression analysis, significant predictors of filled HCQ prescriptions included black/African-American race (OR 1.34, 95% CI (1.17 to 1.46)), hemodialysis (1.50, 95% CI (1.29 to 1.74)), and care from a rheumatologist (5.06, 95% CI (4.56 to 5.62)). Negative predictors of filled HCQ prescriptions included male gender (OR 0.72, 95% CI (0.63 to 0.83)) and those aged 45 years or older (compared to 20 years old and younger, aged 45-64 years, OR 0.66, 95% CI (0.54 to 0.79); aged 65-74 years, OR 0.58, 95% CI (0.44 to 0.76); aged 75 years and older, OR 0.56, 95% CI (0.39 to 0.82)). Conclusions In patients with SLE with ESRD, the dosing strategies for HCQ with regard to potential toxicity and disparities in prescribing patterns need further study.

Original languageEnglish (US)
Pages (from-to)908-910
Number of pages3
JournalJournal of Investigative Medicine
Volume64
Issue number4
DOIs
StatePublished - Jan 1 2016

Fingerprint

Hydroxychloroquine
Systemic Lupus Erythematosus
Chronic Kidney Failure
Prescriptions
Medicare Part D
Dialysis
International Classification of Diseases
Information Systems
Regression analysis
African Americans
Toxicity
Renal Dialysis
Logistics
Cohort Studies
Retrospective Studies
Logistic Models
Regression Analysis
Demography
Databases
Kidney

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Hydroxychloroquine in patients with systemic lupus erythematosus with end-stage renal disease. / Bethel, Monique; Yang, Frances Margaret; Li, Shuang; Nahman, Norris Stanley; Oliver, Alyce M.; Machua, Wambui; Carbone, Laura D.

In: Journal of Investigative Medicine, Vol. 64, No. 4, 01.01.2016, p. 908-910.

Research output: Contribution to journalArticle

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title = "Hydroxychloroquine in patients with systemic lupus erythematosus with end-stage renal disease",
abstract = "Objectives To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). Methods This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710. The prevalence, dosing, and predictors of filled HCQ prescriptions (demographic factors, dialysis type, and provider subspecialty) were determined. Results There were 10,276 patients with SLE identified; 2048 (19.9{\%}) had a prescription for HCQ filled. The mean daily dose of HCQ was 321 mg (range 58-2000 mg). The most common daily doses were 200 (n=768, 37.5{\%}) and 400 mg (n=1161, 56.7{\%}). In multivariable logistic regression analysis, significant predictors of filled HCQ prescriptions included black/African-American race (OR 1.34, 95{\%} CI (1.17 to 1.46)), hemodialysis (1.50, 95{\%} CI (1.29 to 1.74)), and care from a rheumatologist (5.06, 95{\%} CI (4.56 to 5.62)). Negative predictors of filled HCQ prescriptions included male gender (OR 0.72, 95{\%} CI (0.63 to 0.83)) and those aged 45 years or older (compared to 20 years old and younger, aged 45-64 years, OR 0.66, 95{\%} CI (0.54 to 0.79); aged 65-74 years, OR 0.58, 95{\%} CI (0.44 to 0.76); aged 75 years and older, OR 0.56, 95{\%} CI (0.39 to 0.82)). Conclusions In patients with SLE with ESRD, the dosing strategies for HCQ with regard to potential toxicity and disparities in prescribing patterns need further study.",
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T1 - Hydroxychloroquine in patients with systemic lupus erythematosus with end-stage renal disease

AU - Bethel, Monique

AU - Yang, Frances Margaret

AU - Li, Shuang

AU - Nahman, Norris Stanley

AU - Oliver, Alyce M.

AU - Machua, Wambui

AU - Carbone, Laura D

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objectives To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). Methods This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710. The prevalence, dosing, and predictors of filled HCQ prescriptions (demographic factors, dialysis type, and provider subspecialty) were determined. Results There were 10,276 patients with SLE identified; 2048 (19.9%) had a prescription for HCQ filled. The mean daily dose of HCQ was 321 mg (range 58-2000 mg). The most common daily doses were 200 (n=768, 37.5%) and 400 mg (n=1161, 56.7%). In multivariable logistic regression analysis, significant predictors of filled HCQ prescriptions included black/African-American race (OR 1.34, 95% CI (1.17 to 1.46)), hemodialysis (1.50, 95% CI (1.29 to 1.74)), and care from a rheumatologist (5.06, 95% CI (4.56 to 5.62)). Negative predictors of filled HCQ prescriptions included male gender (OR 0.72, 95% CI (0.63 to 0.83)) and those aged 45 years or older (compared to 20 years old and younger, aged 45-64 years, OR 0.66, 95% CI (0.54 to 0.79); aged 65-74 years, OR 0.58, 95% CI (0.44 to 0.76); aged 75 years and older, OR 0.56, 95% CI (0.39 to 0.82)). Conclusions In patients with SLE with ESRD, the dosing strategies for HCQ with regard to potential toxicity and disparities in prescribing patterns need further study.

AB - Objectives To determine dosing patterns and examine predictors of filled hydroxychloroquine (HCQ) prescriptions in patients with systemic lupus erythematosus (SLE) with end-stage renal disease (ESRD). Methods This was a retrospective cohort study of patients with SLE in the US Renal Data System (USRDS) database in fiscal year 2011. All patients were Medicare Part D beneficiaries. Patients with a diagnosis of SLE were identified by the International Classification of Diseases, 9th revision code 710. The prevalence, dosing, and predictors of filled HCQ prescriptions (demographic factors, dialysis type, and provider subspecialty) were determined. Results There were 10,276 patients with SLE identified; 2048 (19.9%) had a prescription for HCQ filled. The mean daily dose of HCQ was 321 mg (range 58-2000 mg). The most common daily doses were 200 (n=768, 37.5%) and 400 mg (n=1161, 56.7%). In multivariable logistic regression analysis, significant predictors of filled HCQ prescriptions included black/African-American race (OR 1.34, 95% CI (1.17 to 1.46)), hemodialysis (1.50, 95% CI (1.29 to 1.74)), and care from a rheumatologist (5.06, 95% CI (4.56 to 5.62)). Negative predictors of filled HCQ prescriptions included male gender (OR 0.72, 95% CI (0.63 to 0.83)) and those aged 45 years or older (compared to 20 years old and younger, aged 45-64 years, OR 0.66, 95% CI (0.54 to 0.79); aged 65-74 years, OR 0.58, 95% CI (0.44 to 0.76); aged 75 years and older, OR 0.56, 95% CI (0.39 to 0.82)). Conclusions In patients with SLE with ESRD, the dosing strategies for HCQ with regard to potential toxicity and disparities in prescribing patterns need further study.

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