Collaboration for the Management of Hydroxychloroquine

The American Academy of Ophthalmology has just formalized a statement cooperation with 3 equivalent societies in rheumatology and dermatology to recognize common principles management for users hydroxychloroquine.1Rosenbaum J.T. Costenbader K. Desmarais J. et al.ACR, AAD, RDS, AAO 2020 joint on hydroxychloroquine use respect retinal toxicity.Arthritis Rheum. 2021 Feb 9; (Online ahead print)https://doi.org/10.1002/art.41683Crossref Scopus (12) Google Scholar These are derived from the established recommendations Ophthalmology2Marmor M.F. Kellner U. Lai T.Y. al.American screening chloroquine retinopathy (2016 revision).Ophthalmology. 2016; 123: 1386-1394Abstract Full Text PDF PubMed (607) College Rheumatology,3American RheumatologyAmerican Rheumatology position statement: retinopathy.https://www.rheumatology.org/Portals/0/Files/Screening-for-Hydroxychloroquine-Retinopathy-Position-Statement.pdf?ver=2016-10-04-170000--000Date: 2016Google but emphasize importance interspecialty achieve optimal care minimal medical or visual complications. implications ophthalmology clear. Ophthalmologists responsible primarily advising about complications hydroxychloroquine, drug is prescribed by internists dermatologists immune, infectious, dermatologic disease. must be collaborative effective both treating those diseases preventing loss. sometimes complain that their colleagues do not like it when they tell patients stop hydroxychloroquine—but this point. need our judgment severity its loss, equally, we concern patient’s overall welfare. We should “stop” unilaterally, rather discuss nature findings us reach decision. Early questionable signs may merit concern, retesting, closer observation, dose reduction, so forth, decision alter vital medication involve patient entire team all understand risks options. Hydroxychloroquine toxicity takes time develop, there take these steps—as long as avoid progression severe enough stage (e.g., any ophthalmoscopically visible damage) loss becomes likely. A missing piece understanding relationship clinical effectiveness which used. know whether lower doses could if minimally exists. hope more active collaboration will induce rheumatologic seek answers. This new does change advice dosing (≤ 5 mg/kg actual weight) imaging field testing.2Marmor However, focus change. critical managing risk toxicity, alone. Prescribers improve communication ophthalmologists hydroxychloroquine; prescribers safety concerns. urge you read brief document either print1Rosenbaum website (https://www.aao.org/guidelines-browse?filter=Clinical%20Statements&sub=ONE.ContentTypes.ClinicalStatement).