In 2016 the American Academy of Ophthalmology (2016-AAO) recommended a maximum daily use of hydroxychloroquine of 5.0 mg/kg real bodyweight to reduce eye toxicity.
In this cross-sectional study, 108 patients with lupus nephritis were prescribed the 2016-AAO recommended dose for ≥3 months. The 32% (n = 108) of patients who were obese received a lower prescribed daily dose when using real bodyweight recommendations due to reaching the maximum daily dose limit. However, the median hydroxychloroquine blood level was significantly higher in obese patients compared to patients who were not obese.
When 2016-AAO recommended doses were used without restricting the maximum daily dose, median hydroxychloroquine blood levels were significantly higher in patients who were obese than in patients without obesity although both groups had a comparable daily dose.
Pedrosa T, Kupa LVK, Pasoto SG, et al. The influence of obesity on hydroxychloroquine blood levels in lupus nephritis patients. Lupus. 2021;961203320985214. DOI: 10.1177/0961203320985214. Epub ahead of print. PMID: 33402039.