Team: Plaquenil Pioneers
Authors: Lankenau Internal Medicine Residents
- Amanda Rodriguez, DO, Internal Medicine Resident, Lankenau Medical Center
- Emily Thoman, DO, Internal Medicine Resident, Lankenau Medical Center
- Michael Galperin, DO, Internal Medicine Resident, Lankenau Medical Center
- Sebastiano Porcu, MD, Internal Medicine Resident, Lankenau Medical Center
- Stephanie Giattino, MD, Associate Program Director, Internal Medicine Residency, Lankenau Medical Center
Team Overview:
Welcome to the court of hydroxychloroquine screening guidelines! Our starting player, hydroxychloroquine (HCQ), a fan favorite dropping buckets left and right in the treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), can come with a catch: HCQ-induced retinopathy, an opponent no one wants to face (a real ankle breaker). Current screening guidelines from the American Academy of Ophthalmology, recommend all patients start with an eye screening in their first year of HCQ treatment, then annually after 5 years on HCQ therapy in low-risk patients. While these guidelines are effective in catching HCQ-induced retinopathy, this rigorous screening adds to the already burdensome waitlists for Ophthalmology clinics and contributes to increased medical and societal costs, including worsened quality of life and productivity losses.
A team of researchers in the Netherlands set out to challenge these guidelines, and they certainly brought their “A-game” in this study, spotlighting 359 patients. For low-risk patients, it is more cost-effective to delay follow-up screenings to ten years after the initial screening and then switch to every two years. For high-risk patients, annual screenings are more efficient starting at five years, rather than the one-year mark. This strategic game plan can help keep patients in the paint with an effective treatment, while reducing wait times for Ophthalmology offices and improving screening cost efficiency. You hear that? That’s all net, baby!
Related content on theMednet.org:
