Taiwanese hospital's big data analysis clarifies lupus drug risks based on age

A groundbreaking big data analysis from National Cheng Kung University Hospital (NCKUH) in Taiwan offers crucial insights into managing lupus patients' treatment, particularly concerning the use of hydroxychloroquine (HCQ) and the risk of vision loss.

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The best approach is to have regular eye check-ups; the image is a situational photo.

For years, clinicians have grappled with the dilemma of prescribing HCQ, a foundational treatment for systemic lupus erythematosus (SLE), while simultaneously worrying about its potential for irreversible retinal damage. The NCKUH research team analyzed data from over 23,000 lupus patients over five years, using Taiwan's National Health Insurance database. Their findings indicate that age is a critical determinant of risk.

The study confirms that a daily dose of 400mg of HCQ provides significant cardiovascular benefits, reducing the risk of coronary artery disease by 14% and venous thrombosis by up to 60%. Crucially, patients under 45 years old can take this high dose without an increased risk of retinal damage. However, for patients over 45, the risk of retinopathy increases significantly, by a factor of 1.87, necessitating careful evaluation and monitoring.

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Patients under 45 years old can take 400mg high dose without increasing the risk of retinal damage, and can enjoy the cardiovascular protection brought by the drug.

This research provides a more precise basis for clinical drug use, enabling doctors and patients to objectively assess the pros and cons of HCQ. The findings were published in the prestigious journal Arthritis & Rheumatology. The team also highlighted that less than 30% of Taiwanese lupus patients undergo regular eye screenings. They urge patients not to stop or avoid treatment due to fear of side effects but to prioritize regular ophthalmological check-ups. Personalized treatment plans, considering age and disease severity, can help achieve a balance between controlling lupus and protecting vision.

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For older patients over 45 years old, if they use high doses, the risk of retinal damage will significantly increase by 1.87 times and needs careful evaluation.