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Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence
BACKGROUND: Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517694/ https://www.ncbi.nlm.nih.gov/pubmed/32977856 http://dx.doi.org/10.1186/s13075-020-02291-z |
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author | Blanchet, Benoit Jallouli, Moez Allard, Marie Ghillani-Dalbin, Pascale Galicier, Lionel Aumaître, Olivier Chasset, François Le Guern, Véronique Lioté, Frédéric Smail, Amar Limal, Nicolas Perard, Laurent Desmurs-Clavel, Hélène Le Thi Huong, Du Asli, Bouchra Kahn, Jean-Emmanuel Sailler, Laurent Ackermann, Félix Papo, Thomas Sacré, Karim Fain, Olivier Stirnemann, Jérôme Cacoub, Patrice Leroux, Gaelle Cohen-Bittan, Judith Sellam, Jérémie Mariette, Xavier Goulvestre, Claire Hulot, Jean Sébastien Amoura, Zahir Vidal, Michel Piette, Jean-Charles Jourde-Chiche, Noémie Costedoat-Chalumeau, Nathalie |
author_facet | Blanchet, Benoit Jallouli, Moez Allard, Marie Ghillani-Dalbin, Pascale Galicier, Lionel Aumaître, Olivier Chasset, François Le Guern, Véronique Lioté, Frédéric Smail, Amar Limal, Nicolas Perard, Laurent Desmurs-Clavel, Hélène Le Thi Huong, Du Asli, Bouchra Kahn, Jean-Emmanuel Sailler, Laurent Ackermann, Félix Papo, Thomas Sacré, Karim Fain, Olivier Stirnemann, Jérôme Cacoub, Patrice Leroux, Gaelle Cohen-Bittan, Judith Sellam, Jérémie Mariette, Xavier Goulvestre, Claire Hulot, Jean Sébastien Amoura, Zahir Vidal, Michel Piette, Jean-Charles Jourde-Chiche, Noémie Costedoat-Chalumeau, Nathalie |
author_sort | Blanchet, Benoit |
collection | PubMed |
description | BACKGROUND: Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points can be established to identify non-adherent patients. METHODS: HCQ levels were measured in serum and whole blood from 573 patients with systemic lupus erythematosus (SLE). The risk factors for active SLE (SLEDAI score > 4) were identified by multiple logistic regression. Serum HCQ levels were measured in 68 additional patients known to be non-adherent, i.e. with whole-blood HCQ < 200 ng/mL. RESULTS: The mean (± SD) HCQ levels were 469 ± 223 ng/mL in serum and 916 ± 449 ng/mL in whole blood. The mean ratio of serum/whole-blood HCQ levels was 0.53 ± 0.15. In the multivariate analysis, low whole-blood HCQ levels (P = 0.023), but not serum HCQ levels, were independently associated with active SLE. From the mean serum/whole-blood level ratio, a serum HCQ level of 106 ng/mL was extrapolated as the corresponding cut-off to identify non-adherent patients with a sensitivity of 0.87 (95% CI 0.76–0.94) and specificity of 0.89 (95% CI 0.72–0.98). All serum HCQ levels of patients with whole-blood HCQ below the detectable level (< 20 ng/mL) were also undetectable (< 20 ng/mL). CONCLUSIONS: These data suggest that whole blood is better than serum for assessing the pharmacokinetic/pharmacodynamic relation of HCQ. Our results support the use of serum HCQ levels to assess non-adherence when whole blood is unavailable. |
format | Online Article Text |
id | pubmed-7517694 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75176942020-09-25 Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence Blanchet, Benoit Jallouli, Moez Allard, Marie Ghillani-Dalbin, Pascale Galicier, Lionel Aumaître, Olivier Chasset, François Le Guern, Véronique Lioté, Frédéric Smail, Amar Limal, Nicolas Perard, Laurent Desmurs-Clavel, Hélène Le Thi Huong, Du Asli, Bouchra Kahn, Jean-Emmanuel Sailler, Laurent Ackermann, Félix Papo, Thomas Sacré, Karim Fain, Olivier Stirnemann, Jérôme Cacoub, Patrice Leroux, Gaelle Cohen-Bittan, Judith Sellam, Jérémie Mariette, Xavier Goulvestre, Claire Hulot, Jean Sébastien Amoura, Zahir Vidal, Michel Piette, Jean-Charles Jourde-Chiche, Noémie Costedoat-Chalumeau, Nathalie Arthritis Res Ther Research Article BACKGROUND: Hydroxychloroquine (HCQ) levels can be measured in both serum and whole blood. No cut-off point for non-adherence has been established in serum nor have these methods ever been compared. The aims of this study were to compare these two approaches and determine if serum HCQ cut-off points can be established to identify non-adherent patients. METHODS: HCQ levels were measured in serum and whole blood from 573 patients with systemic lupus erythematosus (SLE). The risk factors for active SLE (SLEDAI score > 4) were identified by multiple logistic regression. Serum HCQ levels were measured in 68 additional patients known to be non-adherent, i.e. with whole-blood HCQ < 200 ng/mL. RESULTS: The mean (± SD) HCQ levels were 469 ± 223 ng/mL in serum and 916 ± 449 ng/mL in whole blood. The mean ratio of serum/whole-blood HCQ levels was 0.53 ± 0.15. In the multivariate analysis, low whole-blood HCQ levels (P = 0.023), but not serum HCQ levels, were independently associated with active SLE. From the mean serum/whole-blood level ratio, a serum HCQ level of 106 ng/mL was extrapolated as the corresponding cut-off to identify non-adherent patients with a sensitivity of 0.87 (95% CI 0.76–0.94) and specificity of 0.89 (95% CI 0.72–0.98). All serum HCQ levels of patients with whole-blood HCQ below the detectable level (< 20 ng/mL) were also undetectable (< 20 ng/mL). CONCLUSIONS: These data suggest that whole blood is better than serum for assessing the pharmacokinetic/pharmacodynamic relation of HCQ. Our results support the use of serum HCQ levels to assess non-adherence when whole blood is unavailable. BioMed Central 2020-09-25 2020 /pmc/articles/PMC7517694/ /pubmed/32977856 http://dx.doi.org/10.1186/s13075-020-02291-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Blanchet, Benoit Jallouli, Moez Allard, Marie Ghillani-Dalbin, Pascale Galicier, Lionel Aumaître, Olivier Chasset, François Le Guern, Véronique Lioté, Frédéric Smail, Amar Limal, Nicolas Perard, Laurent Desmurs-Clavel, Hélène Le Thi Huong, Du Asli, Bouchra Kahn, Jean-Emmanuel Sailler, Laurent Ackermann, Félix Papo, Thomas Sacré, Karim Fain, Olivier Stirnemann, Jérôme Cacoub, Patrice Leroux, Gaelle Cohen-Bittan, Judith Sellam, Jérémie Mariette, Xavier Goulvestre, Claire Hulot, Jean Sébastien Amoura, Zahir Vidal, Michel Piette, Jean-Charles Jourde-Chiche, Noémie Costedoat-Chalumeau, Nathalie Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title | Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title_full | Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title_fullStr | Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title_full_unstemmed | Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title_short | Hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
title_sort | hydroxychloroquine levels in patients with systemic lupus erythematosus: whole blood is preferable but serum levels also detect non-adherence |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517694/ https://www.ncbi.nlm.nih.gov/pubmed/32977856 http://dx.doi.org/10.1186/s13075-020-02291-z |
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