2026-06-29T02:02:21Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1128622025-03-18T13:49:37Zcom_20.500.14352_14col_20.500.14352_15

Long-term use of antimalarial drugs in rheumatic diseases Jover Jover, Juan Ángel León Mateos, Leticia Pato, Esperanza Loza, E. Rosales Rosado, Zulema Matias, M. A. Méndez Fernández, Ramiro Jesús Díaz Valle, David Benítez Del Castillo Sánchez, José Manuel Abásolo Alcázar, Lydia 616.72 Rheumatic diseases Antimalarials Long-term use Safety Ciencias Biomédicas Reumatología 32 Ciencias Médicas 3205.09 Reumatología Objectives: To evaluate long-term use of antimalarial drugs and to analyse all causes of discontinuation. Methods: This is a retrospective study of a cohort of rheumatic diseases patients on antimalarials, during a maximum period of 17.5 years. Case was defined as antimalarial treatment discontinuation due to: a) lack of efficacy, b) adverse events, and c) other causes. Survival techniques were used to estimate the incidence rate (IR) per 1,000 patient-years with the 95% Confidence Interval (95% CI) of antimalarial treatment discontinuation. Cox regression models were conducted to evaluate possible associated factors to antimalarial discontinuation. Results: One thousand, two hundred and ninety-one medical records were reviewed, and 778 patients were included. Patients started 869 different courses of treatment, with a total follow-up of 2,263 person-years. The IR of global discontinuation was 204 (95% CI 186-224). Fifty-two per cent of the treatments stopped were related to adverse events, 14% to lack of efficacy; and 34% to other reasons (refusal to take medication, ocular comorbidity, remission, or pregnancy). Adverse events discontinuations were related to non-ophthalmologic reasons in 54.5% (gastrointestinal, neuro-psychiatric, skin problems), and to ophthalmologic adverse events in 45.5%. Nine patients suffered definite presence of antimalarial retinopathy (IR: 3.97 [IC 95%: 2.06-7.62]) and one of them irreversible loss of vision (IR: 0.44 [IC 95%: 0.06-3.12]). Women, increasing age, and chloroquine vs. hydroxychloroquine use, increased the risk of discontinuation due to ophthalmologic adverse events. Conclusion: Results suggest that antimalarials have a good balance between benefit and risk. However, we noted a number of discontinuations due to both inefficacy and adverse events. The potential for an unusual but serious ophthalmologic toxicity emphasises the importance of close ophthalmologic monitoring Depto. de Inmunología, Oftalmología y ORL Fac. de Medicina TRUE pub 2024-12-18T09:07:05Z 2024-12-18T09:07:05Z 2012-03-10 journal article VoR https://hdl.handle.net/20.500.14352/112862 0392-856X 1593-098X eng Jover JA, Leon L, Pato E, Loza E, Rosales Z, Matias MA, Mendez-Fernandez R, Díaz-Valle D, Benitez-Del-Castillo JM, Abasolo L. Long-term use of antimalarial drugs in rheumatic diseases. Clin Exp Rheumatol. 2012 May-Jun;30(3):380-7 restricted access application/pdf Pisa Clinical and experimental rheumatology