Lecture 7: CS DMARDs, Hydroxychloroquine, Clinical use in Rheumatology- Safety concern, Precautions and Management

This video explores the clinical use, safety, and monitoring of Hydroxychloroquine (HCQ) in rheumatology, focusing on its role in Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA).

Key Highlights:

  • Weight-based dosing (≤5 mg/kg/day actual body weight) to maximize efficacy and reduce toxicity.
  • Therapeutic benefits as a disease-modifying and steroid-sparing agent.
  • Major safety concerns including retinal toxicity, cardiac toxicity (QT prolongation, cardiomyopathy), and neuromuscular/cutaneous adverse effects.
  • High-risk factors such as treatment >5 years, cumulative dose >1000 g, renal impairment, and tamoxifen use.
  • Importance of baseline and annual ophthalmic screening (SD-OCT, FAF, visual fields), routine monitoring, and timely management of toxicity, including drug discontinuation when indicated.