Abstract：
UNASSIGNED: Hydroxychloroquine (HCQ) and glucocorticoids (GCs) constitute the oldest and more used drugs in the treatment of systemic lupus erythematosus (SLE). Despite this long experience, both are still subject to a number of uncertainties, mainly regarding the dose.
UNASSIGNED: We review the main mechanisms of action, the clinical and toxic effects of HCQ and GCs and analyze the recommendations for the use of both in guidelines published since 2018. We offer a set of recommendations based on the pharmacology, mechanisms of action and clinical evidence.
UNASSIGNED: HCQ is the backbone therapy for SLE, and a judicious use must be accomplished, using doses that allow a good control of lupus without compromising the safety of treatments very much prolonged over the time. Stable doses of 200 mg/day seem to accomplish both conditions. GCs should be used more judiciously, with methyl-prednisolone pulses as the main therapy for inducing rapid remission and doses ≤5-2.5 mg/day be never exceeded in long-term maintenance treatments.
UNASSIGNED: We review the main mechanisms of action, the clinical and toxic effects of HCQ and GCs and analyze the recommendations for the use of both in guidelines published since 2018. We offer a set of recommendations based on the pharmacology, mechanisms of action and clinical evidence.
UNASSIGNED: HCQ is the backbone therapy for SLE, and a judicious use must be accomplished, using doses that allow a good control of lupus without compromising the safety of treatments very much prolonged over the time. Stable doses of 200 mg/day seem to accomplish both conditions. GCs should be used more judiciously, with methyl-prednisolone pulses as the main therapy for inducing rapid remission and doses ≤5-2.5 mg/day be never exceeded in long-term maintenance treatments.
摘要：
■羟氯喹（HCQ）和糖皮质激素（GCs）构成了治疗系统性红斑狼疮（SLE）的最古老且使用较多的药物。尽管经历了这么长时间,两者在剂量方面仍然存在许多不确定性.
■我们回顾了主要的行动机制，HCQ和GCs的临床和毒性作用，并分析了2018年以来发布的指南中使用HCQ和GCs的建议。我们提供了一套基于药理学的建议，作用机制和临床证据。
■HCQ是SLE的骨干疗法，必须明智地使用，使用剂量可以很好地控制狼疮，而不会影响治疗的安全性。200mg/天的稳定剂量似乎可以实现这两种条件。GCs应该更明智地使用，甲基强的松龙脉冲作为诱导快速缓解的主要疗法，长期维持治疗中剂量≤5-2.5mg/天。
■我们回顾了主要的行动机制，HCQ和GCs的临床和毒性作用，并分析了2018年以来发布的指南中使用HCQ和GCs的建议。我们提供了一套基于药理学的建议，作用机制和临床证据。
■HCQ是SLE的骨干疗法，必须明智地使用，使用剂量可以很好地控制狼疮，而不会影响治疗的安全性。200mg/天的稳定剂量似乎可以实现这两种条件。GCs应该更明智地使用，甲基强的松龙脉冲作为诱导快速缓解的主要疗法，长期维持治疗中剂量≤5-2.5mg/天。
