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 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.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
---|---|
Enthalten in: |
Arthritis research & therapy - 22(2020), 1 vom: 25. Sept., Seite 223 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Blanchet, Benoit [VerfasserIn] |
---|
Links: |
---|
Themen: |
4QWG6N8QKH |
---|
Anmerkungen: |
Date Completed 21.06.2021 Date Revised 21.06.2021 published: Electronic Citation Status MEDLINE |
---|
doi: |
10.1186/s13075-020-02291-z |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM315486139 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM315486139 | ||
003 | DE-627 | ||
005 | 20231225155023.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s13075-020-02291-z |2 doi | |
028 | 5 | 2 | |a pubmed24n1051.xml |
035 | |a (DE-627)NLM315486139 | ||
035 | |a (NLM)32977856 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Blanchet, Benoit |e verfasserin |4 aut | |
245 | 1 | 0 | |a Hydroxychloroquine levels in patients with systemic lupus erythematosus |b whole blood is preferable but serum levels also detect non-adherence |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 21.06.2021 | ||
500 | |a Date Revised 21.06.2021 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a 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 | ||
520 | |a 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 | ||
520 | |a 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) | ||
520 | |a 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 | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Adherence | |
650 | 4 | |a Drug monitoring | |
650 | 4 | |a Hydroxychloroquine | |
650 | 4 | |a Serum | |
650 | 4 | |a Systemic lupus erythematosus | |
650 | 7 | |a Antirheumatic Agents |2 NLM | |
650 | 7 | |a Hydroxychloroquine |2 NLM | |
650 | 7 | |a 4QWG6N8QKH |2 NLM | |
700 | 1 | |a Jallouli, Moez |e verfasserin |4 aut | |
700 | 1 | |a Allard, Marie |e verfasserin |4 aut | |
700 | 1 | |a Ghillani-Dalbin, Pascale |e verfasserin |4 aut | |
700 | 1 | |a Galicier, Lionel |e verfasserin |4 aut | |
700 | 1 | |a Aumaître, Olivier |e verfasserin |4 aut | |
700 | 1 | |a Chasset, François |e verfasserin |4 aut | |
700 | 1 | |a Le Guern, Véronique |e verfasserin |4 aut | |
700 | 1 | |a Lioté, Frédéric |e verfasserin |4 aut | |
700 | 1 | |a Smail, Amar |e verfasserin |4 aut | |
700 | 1 | |a Limal, Nicolas |e verfasserin |4 aut | |
700 | 1 | |a Perard, Laurent |e verfasserin |4 aut | |
700 | 1 | |a Desmurs-Clavel, Hélène |e verfasserin |4 aut | |
700 | 1 | |a Le Thi Huong, Du |e verfasserin |4 aut | |
700 | 1 | |a Asli, Bouchra |e verfasserin |4 aut | |
700 | 1 | |a Kahn, Jean-Emmanuel |e verfasserin |4 aut | |
700 | 1 | |a Sailler, Laurent |e verfasserin |4 aut | |
700 | 1 | |a Ackermann, Félix |e verfasserin |4 aut | |
700 | 1 | |a Papo, Thomas |e verfasserin |4 aut | |
700 | 1 | |a Sacré, Karim |e verfasserin |4 aut | |
700 | 1 | |a Fain, Olivier |e verfasserin |4 aut | |
700 | 1 | |a Stirnemann, Jérôme |e verfasserin |4 aut | |
700 | 1 | |a Cacoub, Patrice |e verfasserin |4 aut | |
700 | 1 | |a Leroux, Gaelle |e verfasserin |4 aut | |
700 | 1 | |a Cohen-Bittan, Judith |e verfasserin |4 aut | |
700 | 1 | |a Sellam, Jérémie |e verfasserin |4 aut | |
700 | 1 | |a Mariette, Xavier |e verfasserin |4 aut | |
700 | 1 | |a Goulvestre, Claire |e verfasserin |4 aut | |
700 | 1 | |a Hulot, Jean Sébastien |e verfasserin |4 aut | |
700 | 1 | |a Amoura, Zahir |e verfasserin |4 aut | |
700 | 1 | |a Vidal, Michel |e verfasserin |4 aut | |
700 | 1 | |a Piette, Jean-Charles |e verfasserin |4 aut | |
700 | 0 | |a PLUS Group |e verfasserin |4 aut | |
700 | 1 | |a Jourde-Chiche, Noémie |e verfasserin |4 aut | |
700 | 1 | |a Costedoat-Chalumeau, Nathalie |e verfasserin |4 aut | |
700 | 1 | |a Astudillo, Leonardo |e investigator |4 oth | |
700 | 1 | |a Belizna, Cristina |e investigator |4 oth | |
700 | 1 | |a Belmatoug, Nadia |e investigator |4 oth | |
700 | 1 | |a Benveniste, Olivier |e investigator |4 oth | |
700 | 1 | |a Benyamine, Audrey |e investigator |4 oth | |
700 | 1 | |a Bezanahary, Holly |e investigator |4 oth | |
700 | 1 | |a Blanco, Patrick |e investigator |4 oth | |
700 | 1 | |a Bodaghi, Bahram |e investigator |4 oth | |
700 | 1 | |a Bourgeois, Pierre |e investigator |4 oth | |
700 | 1 | |a Brihaye, Benoît |e investigator |4 oth | |
700 | 1 | |a Chatelus, Emmanuel |e investigator |4 oth | |
700 | 1 | |a Damade, Richard |e investigator |4 oth | |
700 | 1 | |a Daugas, Eric |e investigator |4 oth | |
700 | 1 | |a De Gennes, Christian |e investigator |4 oth | |
700 | 1 | |a Delfraissy, Jean-François |e investigator |4 oth | |
700 | 1 | |a Delluc, Céline |e investigator |4 oth | |
700 | 1 | |a Delluc, Aurélien |e investigator |4 oth | |
700 | 1 | |a Duhaut, Pierre |e investigator |4 oth | |
700 | 1 | |a Dupuy, Alain |e investigator |4 oth | |
700 | 1 | |a Durieu, Isabelle |e investigator |4 oth | |
700 | 1 | |a Ea, Hang Korng |e investigator |4 oth | |
700 | 1 | |a Farge, Dominique |e investigator |4 oth | |
700 | 1 | |a Funck-Brentano, Christian |e investigator |4 oth | |
700 | 1 | |a Gandjbakhch, Frédérique |e investigator |4 oth | |
700 | 1 | |a Gellen-Dautremer, Justine |e investigator |4 oth | |
700 | 1 | |a Godeau, Bertrand |e investigator |4 oth | |
700 | 1 | |a Goujard, Cécile |e investigator |4 oth | |
700 | 1 | |a Grandpeix, Catherine |e investigator |4 oth | |
700 | 1 | |a Grange, Claire |e investigator |4 oth | |
700 | 1 | |a Grimaldi, Lamiae |e investigator |4 oth | |
700 | 1 | |a Guettrot-Imbert, Gaëlle |e investigator |4 oth | |
700 | 1 | |a Guillevin, Loïc |e investigator |4 oth | |
700 | 1 | |a Hachulla, Eric |e investigator |4 oth | |
700 | 1 | |a Harle, Jean-Robert |e investigator |4 oth | |
700 | 1 | |a Haroche, Julien |e investigator |4 oth | |
700 | 1 | |a Hausfater, Pierre |e investigator |4 oth | |
700 | 1 | |a Jouquan, Jean |e investigator |4 oth | |
700 | 1 | |a Kaplanski, Gilles |e investigator |4 oth | |
700 | 1 | |a Keshtmand, Homa |e investigator |4 oth | |
700 | 1 | |a Khellaf, Mehdi |e investigator |4 oth | |
700 | 1 | |a Lambotte, Olivier |e investigator |4 oth | |
700 | 1 | |a Launay, David |e investigator |4 oth | |
700 | 1 | |a Lechat, Philippe |e investigator |4 oth | |
700 | 1 | |a Levesque, Hervé |e investigator |4 oth | |
700 | 1 | |a Lidove, Olivier |e investigator |4 oth | |
700 | 1 | |a Liozon, Eric |e investigator |4 oth | |
700 | 1 | |a Ly, Kim |e investigator |4 oth | |
700 | 1 | |a Mahevas, Matthieu |e investigator |4 oth | |
700 | 1 | |a Mariampillai, Kubéraka |e investigator |4 oth | |
700 | 1 | |a Mathian, Alexis |e investigator |4 oth | |
700 | 1 | |a Mazodier, Karin |e investigator |4 oth | |
700 | 1 | |a Michel, Marc |e investigator |4 oth | |
700 | 1 | |a Morel, Nathalie |e investigator |4 oth | |
700 | 1 | |a Mouthon, Luc |e investigator |4 oth | |
700 | 1 | |a Musset, Lucile |e investigator |4 oth | |
700 | 1 | |a Ngack, Rokiya |e investigator |4 oth | |
700 | 1 | |a Ninet, Jacques |e investigator |4 oth | |
700 | 1 | |a Oksenhendler, Eric |e investigator |4 oth | |
700 | 1 | |a Pellegrin, Jean-Luc |e investigator |4 oth | |
700 | 1 | |a Peyr, Olivier |e investigator |4 oth | |
700 | 1 | |a Piette, Anne-Marie |e investigator |4 oth | |
700 | 1 | |a Poindron, Vincent |e investigator |4 oth | |
700 | 1 | |a Pourrat, Jacques |e investigator |4 oth | |
700 | 1 | |a Roux, Fabienne |e investigator |4 oth | |
700 | 1 | |a Saadoun, David |e investigator |4 oth | |
700 | 1 | |a Sahali, Sabrinel |e investigator |4 oth | |
700 | 1 | |a Saint-Marcoux, Bernadette |e investigator |4 oth | |
700 | 1 | |a Sarrot-Reynauld, Françoise |e investigator |4 oth | |
700 | 1 | |a Schoindre, Yoland |e investigator |4 oth | |
700 | 1 | |a Sene, Damien |e investigator |4 oth | |
700 | 1 | |a Serratrice, Jacques |e investigator |4 oth | |
700 | 1 | |a Seve, Pascal |e investigator |4 oth | |
700 | 1 | |a Sibilia, Jean |e investigator |4 oth | |
700 | 1 | |a Simon, Claude |e investigator |4 oth | |
700 | 1 | |a Sordet, Christelle |e investigator |4 oth | |
700 | 1 | |a Terrier, Benjamin |e investigator |4 oth | |
700 | 1 | |a Trad, Salim |e investigator |4 oth | |
700 | 1 | |a Viallard, Jean-François |e investigator |4 oth | |
700 | 1 | |a Vidal, Elisabeth |e investigator |4 oth | |
700 | 1 | |a Wechsler, Bertrand |e investigator |4 oth | |
700 | 1 | |a Weiller, Pierre-Jean |e investigator |4 oth | |
773 | 0 | 8 | |i Enthalten in |t Arthritis research & therapy |d 2003 |g 22(2020), 1 vom: 25. Sept., Seite 223 |w (DE-627)NLM124870457 |x 1478-6362 |7 nnns |
773 | 1 | 8 | |g volume:22 |g year:2020 |g number:1 |g day:25 |g month:09 |g pages:223 |
856 | 4 | 0 | |u http://dx.doi.org/10.1186/s13075-020-02291-z |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 22 |j 2020 |e 1 |b 25 |c 09 |h 223 |