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