@article {1323931,
	title = {Hydroxychloroquine prescription trends and predictors for excess dosing per recent ophthalmology guidelines},
	journal = {Arthritis Res Ther},
	volume = {20},
	number = {1},
	year = {2018},
	month = {2018 Jul 05},
	pages = {133},
	abstract = {BACKGROUND: Hydroxychloroquine (HCQ) retinopathy may be more common than previously recognized; recent ophthalmology guidelines have revised recommendations from ideal body weight (IBW)-based dosing to actual body weight (ABW)-based dosing. However, contemporary HCQ prescribing trends in the UK remain unknown. METHODS: We examined a UK general population database to investigate HCQ dosing between 2007 and 2016. We studied trends of excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5\&nbsp;mg/kg of IBW and 5.0\&nbsp;mg/kg of ABW) and determined their independent predictors using multivariable logistic regression analyses. RESULTS: Among 20,933 new HCQ users (78\% female), the proportions of initial HCQ excess dosing declined from 40\% to 36\% using IBW and 38\% to 30\% using ABW, between 2007 and 2016. Among these, 47\% of women were excess-dosed (multivariable OR 12.52; 95\% CI 10.99-14.26) using IBW and 38\% (multivariable OR 1.98; 95\% CI,1.81-2.15) using ABW. Applying IBW, 37\% of normal and 44\% of obese patients were excess-dosed; however, applying ABW, 53\% of normal and 10\% of obese patients were excess-dosed (multivariable ORs = 1.61 and 0.1 (reference = normal); both p \&lt; 0.01). Long-term HCQ users showed similar excess dosing. CONCLUSION: A substantial proportion of HCQ users in the UK, particularly women, may have excess HCQ dosing per the previous or recent weight-based guidelines despite a modest decline in recent years. Over half of normal-BMI individuals were excess-dosed per the latest guidelines. This implies the potential need to reduce dosing for many patients but also calls for further research to establish unifying evidence-based safe and effective dosing strategies.},
	issn = {1478-6362},
	doi = {10.1186/s13075-018-1634-8},
	author = {Jorge, April M and Melles, Ronald B and Zhang, Yuqing and Lu, Na and Rai, Sharan K and Young, Lucy H and Costenbader, Karen H and Ramsey-Goldman, Rosalind and Lim, S Sam and Esdaile, John M and Clarke, Ann E and Urowitz, M B and Askanase, Anca and Aranow, Cynthia and Petri, Michelle and Choi, Hyon}
}
