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Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines

PURPOSE: The aim of this study was to determine whether somatotype influences the risk of hydroxychloroquine (HC) retinopathy (HCR) and whether dosing by real body weight (RBW), ideal body weight (IBW), or the lesser of these better predicts the risk of HCR. PATIENTS AND METHODS: A total of 565 pati...

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Autores principales: Browning, David J, Lee, Chong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939880/
https://www.ncbi.nlm.nih.gov/pubmed/29765194
http://dx.doi.org/10.2147/OPTH.S163451
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author Browning, David J
Lee, Chong
author_facet Browning, David J
Lee, Chong
author_sort Browning, David J
collection PubMed
description PURPOSE: The aim of this study was to determine whether somatotype influences the risk of hydroxychloroquine (HC) retinopathy (HCR) and whether dosing by real body weight (RBW), ideal body weight (IBW), or the lesser of these better predicts the risk of HCR. PATIENTS AND METHODS: A total of 565 patients taking HC for whom height and weight were recorded and a sensitive ancillary testing modality was used including 10-2 visual fields, spectral domain optical coherence tomography, fundus autofluorescence imaging, and multifocal electroretinography were enrolled. Body mass index (BMI) was compared for patients without and with HCR. Logistic regression models of age, cumulative dose, and daily dosing based on RBW, IBW, or lesser of these were compared. Area under the curve (AUC) of receiver operating characteristic plots was used to assess the diagnostic accuracy of RBW, IBW, and lesser of these guidelines for safe dosing. Probability plots for the risk of retinopathy versus BMI were compared for the different recommended guidelines on safe dosing. RESULTS: A total of 41 patients had HCR. The median BMI was 27.6 (interquartile range [IQR] 24.3, 32.6) and 24.0 (IQR 21.0, 31.6) for patients without and with HCR (P=0.0102), respectively. AUC for univariate receiver operating characteristic plots of retinopathy versus dosing by RBW, IBW, and lesser of these was 0.71, 0.72, and 0.76, respectively. AUC for multivariate receiver operating characteristic plots of retinopathy versus models incorporating gender, age, cumulative dose, and BMI and differing by including dosing by RBW, IBW, and lesser of these was 0.82, 0.82, and 0.83, respectively. For all of the multivariate logistic models, the risk of retinopathy was higher for lower BMIs. CONCLUSION: Short, asthenic women are at higher risk for HCR. The 2011 American Academy of Ophthalmology (AAO) guidelines are safer for short, obese women. The 2016 AAO guidelines are safer for short, asthenic patients. Choosing daily dosing based on the lesser of the RBW and IBW guidelines is safer for all patients.
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spelling pubmed-59398802018-05-14 Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines Browning, David J Lee, Chong Clin Ophthalmol Original Research PURPOSE: The aim of this study was to determine whether somatotype influences the risk of hydroxychloroquine (HC) retinopathy (HCR) and whether dosing by real body weight (RBW), ideal body weight (IBW), or the lesser of these better predicts the risk of HCR. PATIENTS AND METHODS: A total of 565 patients taking HC for whom height and weight were recorded and a sensitive ancillary testing modality was used including 10-2 visual fields, spectral domain optical coherence tomography, fundus autofluorescence imaging, and multifocal electroretinography were enrolled. Body mass index (BMI) was compared for patients without and with HCR. Logistic regression models of age, cumulative dose, and daily dosing based on RBW, IBW, or lesser of these were compared. Area under the curve (AUC) of receiver operating characteristic plots was used to assess the diagnostic accuracy of RBW, IBW, and lesser of these guidelines for safe dosing. Probability plots for the risk of retinopathy versus BMI were compared for the different recommended guidelines on safe dosing. RESULTS: A total of 41 patients had HCR. The median BMI was 27.6 (interquartile range [IQR] 24.3, 32.6) and 24.0 (IQR 21.0, 31.6) for patients without and with HCR (P=0.0102), respectively. AUC for univariate receiver operating characteristic plots of retinopathy versus dosing by RBW, IBW, and lesser of these was 0.71, 0.72, and 0.76, respectively. AUC for multivariate receiver operating characteristic plots of retinopathy versus models incorporating gender, age, cumulative dose, and BMI and differing by including dosing by RBW, IBW, and lesser of these was 0.82, 0.82, and 0.83, respectively. For all of the multivariate logistic models, the risk of retinopathy was higher for lower BMIs. CONCLUSION: Short, asthenic women are at higher risk for HCR. The 2011 American Academy of Ophthalmology (AAO) guidelines are safer for short, obese women. The 2016 AAO guidelines are safer for short, asthenic patients. Choosing daily dosing based on the lesser of the RBW and IBW guidelines is safer for all patients. Dove Medical Press 2018-05-03 /pmc/articles/PMC5939880/ /pubmed/29765194 http://dx.doi.org/10.2147/OPTH.S163451 Text en © 2018 Browning and Lee. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Browning, David J
Lee, Chong
Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title_full Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title_fullStr Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title_full_unstemmed Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title_short Somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
title_sort somatotype, the risk of hydroxychloroquine retinopathy, and safe daily dosing guidelines
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5939880/
https://www.ncbi.nlm.nih.gov/pubmed/29765194
http://dx.doi.org/10.2147/OPTH.S163451
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