Prevalence and risk factors for chloroquine maculopathy and role of plasma chloroquine and desethylchloroquine concentrations in predicting chloroquine maculopathy

Aim To determine the prevalence and to identify the risk factors of chloroquine maculopathy (CM), and to evaluate the association of plasma chloroquine (CQ) and desethylchloroquine (DCQ) levels and CM. Methods Rheumatoid arthritis (RA) patients who had taken CQ for at least 6 months and stable CQ do...

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Bibliographic Details
Published in:	International journal of rheumatic diseases Vol. 16; no. 1; pp. 47 - 55
Main Authors:	Chiowchanwisawakit, Praveena, Nilganuwong, Surasak, Srinonprasert, Varalak, Boonprasert, Rasada, Chandranipapongse, Weerawadee, Chatsiricharoenkul, Somruedee, Katchamart, Wanruchada, Pongnarin, Piyapat, Danwiriyakul, Wimonrat, Koolvisoot, Ajchara, Arromdee, Emvalee, Ruangvaravate, Ngamkae
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-02-2013 Wiley Subscription Services, Inc
Subjects:	antimalarial drug Antirheumatic Agents - adverse effects Chloroquine - adverse effects Chloroquine - analogs & derivatives Chloroquine - blood chloroquine maculopathy Chromatography, High Pressure Liquid Cross-Sectional Studies Female Humans Humphrey visual field Male Middle Aged Multivariate analysis Plasma plasma chloroquine levels plasma desethylchloroquine levels Prevalence Retinal Diseases - chemically induced Retinal Diseases - epidemiology Retinal Diseases - pathology Risk Factors Tandem Mass Spectrometry Thailand - epidemiology Thailand
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Summary:	Aim To determine the prevalence and to identify the risk factors of chloroquine maculopathy (CM), and to evaluate the association of plasma chloroquine (CQ) and desethylchloroquine (DCQ) levels and CM. Methods Rheumatoid arthritis (RA) patients who had taken CQ for at least 6 months and stable CQ dosage for at least 2 months were included. CM was diagnosed by dilated ocular examination and automated visual field. Plasma CQ and DCQ levels were determined by liquid chromatography tandem mass spectrometry method. Logistic regression was used to explore risk factors associated with CM. Results One hundred and ninety‐three patients were included with median CQ duration (range) of 50.2 months (6.0–269.8) and cumulative dose of 137.4 g (16.4–1226.5). The prevalence of CM was 13.5%. Factors associated with CM identified from univariate analysis were age > 60 years, and creatinine clearance with odds ratio (OR) (95%CI) of 5.79 (2.42, 13.84), and 0.98 (0.96, 1.00). In multivariate analysis, older age, usage > 5 years, and current dose from 2.5 mg/kg ideal body weight [IBW]/day were the factors significantly associated with CM with OR of 5.89 (2.38, 14.57), 2.94 (1.10, 7.83), and 3.32 (1.04, 10.60), respectively, while plasma CQ and DCQ showed no association with CM. Conclusions The prevalence of CM was 13.5% among RA patients taking CQ for at least 6 months. Age > 60 years, duration of CQ usage > 5 years and current CQ dose ≥2.5 mg/kg IBW/day were the risk factors for CM. The plasma CQ or DCQ levels demonstrated no correlation in developing CM.
Bibliography:	ark:/67375/WNG-TFX39405-8 istex:350C1F6B752606DEDF92BD976379622B5119B5D9 ArticleID:APL12029 Siriraj Research Development Fund - No. R015332001; No. R015232069
ISSN:	1756-1841 1756-185X
DOI:	10.1111/1756-185X.12029