Drs. Celline Brasil and Sasha Bernatsky.

A new study from Dr. Sasha Bernatsky's group on the risk of flares after tapering or discontinuing hydroxychloroquine treatment in systemic lupus erythematosus has been getting a lot of coverage due to its importance after the drug was added to the FDA drug shortage list during the COVID-19 pandemic. The study, Predictors of unsuccessful hydroxychloroquine tapering and discontinuation: Can we personalize decision‐making in systemic lupus treatment? was published in Journal of Arthritis Care and Research.

Our main project aims to understand the risks and benefits of hydroxychloroquine (HCQ) to provide personalized treatment for lupus patients. Knowing the predictors of unsuccessful hydroxychloroquine tapering and discontinuation is the first step to achieve our project’s goal. In our study recently published in Arthritis Care and Research, we observed that some subgroups of patients, including non-Caucasians, those aged 25 years old or younger at lupus diagnosis, and those with active disease, are at higher risk of flaring after HCQ is disrupted. These findings took on new importance with the COVID-19 pandemic since HCQ was added to the FDA drug shortage list, and concerns were raised about the inevitable impact on SLE patients relying on this medication. Outcomes after HCQ tapering or discontinuation was a hot topic in the American College of Rheumatology annual meeting that took place this past November. Our paper is instrumental in answering some of the physicians’ questions regarding HCQ de-escalation or maintenance to guide individual decision making. —Dr. Celline Brasil, first author of the study.

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