Physicians should consider maximum HCQ dose on Ideal weight for patients who are short and obese and real weight for short, thin individuals.
GUIDELINE CHANGE IN DISPUTE
When Dr. Browning's group put this information into a model and analyzed the complete data, they found that the AUCs were identical for the two methods (Figure 7).
"The results on which the guideline change was based have not been replicated, and in fact, are in dispute," Dr. Browning contended.
Instead, it makes more sense to use the ideal body weight method for short, obese patients and the real body weight for short, asthenic patient, he said.
"Our country is the midst of an obesity epidemic," Dr. Browning emphasized. "During the past 50 years, the typical patient who takes HCQ has had an increase in weight of 27.5 lbs which correlates to a 63 mg increase in the ceiling dose if one uses the AAO guidelines. HCQ is concentrated in lean tissues and stored less in fat, making this a dangerous situation."
Dosing HCQ by ideal body weight is unsafe for short asthenic somatotypes, and dosing by real body weight is unsafe for short obese somatotypes. Using the lower dose between ideal and real body weight is safer for all patients.
This article was adapted from Dr. Browning's presentation during the 2017 meeting of the American Academy of Ophthalmology. He had no disclosures that were relevant to this talk.
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