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Table 2 Clinical manifestations and treatment of flares according to the study group

From: Discontinuation of hydroxychloroquine in older patients with systemic lupus erythematosus: a multicenter retrospective study

Patient

Time to flare (months)

Clinical manifestations

Flare (rSFI)

SELENA-SLEDAI score

Treatment

HCQ withdrawal group

 1

2.5

Localized rash (discoid)

Mild

5

HCQ 400 mg/day

 2

2.5

Localized rash (pernio) and arthritis (< 3 joints)

Mild

8

None for 1 year, followed by HCQ

 3

3

Arthritis (> 3 joints)

Moderate

4

MTX 7.5–10 mg/week

 14

6

Localized rash (malar) and alopecia

Mild

4

HCQ 400 mg/day

 26

6

Extensive rash (discoid)

Moderate

2

HCQ 200 mg/day, followed by HCQ 400 mg/day

HCQ continuation group

 28

5

Serositis (pericarditis)

Moderate

4

Pred 30 mg/day + MMF increased to 2 g/day

 30

11

Arthritis (> 3 joints)

Moderate

4

NSAIDs followed by Pred 20 mg/day

 43

4

Alopecia and arthritis (> 3 joints)

Moderate

6

HCQ 600 mg/day

 49

3.5

Extensive rash (discoid) and alopecia

Moderate

7

HCQ 600 mg/day, followed by CQ 250 mg/TIW

 54

8

Extensive rash (discoid) and arthritis (> 3 joints)

Moderate

6

MTX 7.5 mg/week

  1. CQ chloroquine, HCQ hydroxychloroquine, MMF mycophenolate mofetil, MTX methotrexate, NSAID non-steroidal anti-inflammatory drugs, Pred prednisone, rSFI revised version of the SELENA-SLEDAI Flare composite index, SELENA-SLEDAI Safety of Estrogens in Lupus Erythematosus: National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index, TIW three times per week