ABSTRACT
OBJECTIVE:
A multicenter
survey is conducted to study the application,the
long-term effect and
safety of
hydroxychloroquine(HCQ)in the
treatment of
rheumatic diseases in Suzhou.
METHODS:
Retrospectively collect the data of
outpatients and
inpatients from
Rheumatology Department of four
general hospitals in Suzhou(the First Affiliated
Hospital of Suzhou
University, and Suzhou
Hospital of
Traditional Chinese Medicine, the First People's
Hospital of Kunshan, the First People's
Hospital of Changshu)from June 2017 to July 2018. A special
questionnaire was used to collect data on general information,
diagnosis,
methods and
courses in the use of hydroxychloro-quine, duration,
efficacy and
compliance, combined medication, adverse reactions of
ophthalmology and other systems, and the use of
hydroxychloroquine(HCQ)during
pregnancy.Result Totally there were 856 cases, including 68
males(7.9%)and 788
females(92.1%).
Classification of
diseases 147 cases of RA(including
secondary SS of RA), 425 cases of SLE,12 cases of APS, 167 cases of PSS,104 cases of others, and 1 case of overlap
syndrome(RA with SLE)The
treatment course of HCQ minimum 0.5 years, maximum 22.75 years, with an average of 3.59(SD=3.08)years.
Dosage 0.2 g/day in 604 cases, 0.4 g/day in 424 cases, 193 cases of using 0.4 and 0.2 successively, and 21 in other cases;721 cases used continuously. There were adverse reactions in 183 cases(7
males and 176
females), which were distributed in 30 cases of RA, 105 cases of SLE, 2 cases of APS, 31 cases of SS and 15 other cases. Ophthalmological adverse reactions occurred in 70 cases, with positive correlation in 4 cases. Ophthalmological examination 121 cases(14.1%)every year;68 cases(7.9%)every two years. There were 92 cases of adverse
skin reactions, with 8 cases of positive correlation. Other systems had few adverse reactions and there was no positive correlation. Continuous medication, combination of
anti-rheumatic drugs and adverse reactions were associated, and continuous medication or combination of
anti-rheumatic drugs were significantly associated with adverse reactions in
ophthalmology and
skin, respectively. The adverse reactions of
ophthalmology were related to the
course of
treatment, and the adverse reactions of fundus increased after taking
medicine for more than 7 years.There were 37
pregnancies and HCQ was used in 17 cases throughout
pregnancy, and only 1 case had non-
drug-related neonatal defects.
CONCLUSION:
HCQ is mainly used in the
treatment of SLE, SS, RA and APS in
Rheumatology Department in Suzhou. HCQ medication is standardized, but ophthalmic follow-up
monitoring is not. Adverse reactions are mainly in
skin and
ophthalmology. Continuous medication and combination of
antirheumatic drugs are associated factors of adverse reactions.Long-term
treatment with HCQ is safe and well-toleratrd.