Abstract：
BACKGROUND: Hydroxychloroquine (HCQ) is the first-line treatment for systemic lupus erythematosus (SLE); however, there is heterogeneity in its clinical use. This consensus aims to bridge the gap in SLE treatment by providing practical and valuable recommendations for health professionals.
METHODS: The methodology used is based on a systematic literature review and a nominal group technique (NGT). A ten-member scientific committee formulated eight clinically relevant questions. First, a systematic review was conducted to identify the available evidence, which the scientific committee evaluated to developed recommendations based on their expertise, achieving consensus through NGT.
RESULTS: 1673 titles and abstracts were screened, and 43 studies were included for meeting the inclusion criteria. The scientific committee established 11 recommendations for HCQ use in initiation, maintenance, and monitoring, considering benefits and potential adverse effects of HCQ. Unanimous agreement was achieved on all recommendations.
CONCLUSIONS: The available evidence supports HCQ\'s effectiveness and safety for SLE. Individualized assessment of the initial HCQ dose is important, especially in situations requiring dose reduction or discontinuation. This risk-benefit assessment, specifically focusing on the balance between retinal toxicity and the risk of SLE relapse, should guide decisions regarding medication withdrawal, considering disease activity, risk factors, and HCQ potential benefits. Close monitoring is essential for optimal disease management and minimize potential risks, such as QT prolongation or retinal toxicity.
METHODS: The methodology used is based on a systematic literature review and a nominal group technique (NGT). A ten-member scientific committee formulated eight clinically relevant questions. First, a systematic review was conducted to identify the available evidence, which the scientific committee evaluated to developed recommendations based on their expertise, achieving consensus through NGT.
RESULTS: 1673 titles and abstracts were screened, and 43 studies were included for meeting the inclusion criteria. The scientific committee established 11 recommendations for HCQ use in initiation, maintenance, and monitoring, considering benefits and potential adverse effects of HCQ. Unanimous agreement was achieved on all recommendations.
CONCLUSIONS: The available evidence supports HCQ\'s effectiveness and safety for SLE. Individualized assessment of the initial HCQ dose is important, especially in situations requiring dose reduction or discontinuation. This risk-benefit assessment, specifically focusing on the balance between retinal toxicity and the risk of SLE relapse, should guide decisions regarding medication withdrawal, considering disease activity, risk factors, and HCQ potential benefits. Close monitoring is essential for optimal disease management and minimize potential risks, such as QT prolongation or retinal toxicity.
摘要：
背景：羟氯喹（HCQ）是系统性红斑狼疮（SLE）的一线治疗药物；然而，其临床使用存在异质性。这一共识旨在通过为卫生专业人员提供实用和有价值的建议来弥合SLE治疗的差距。
方法：使用的方法基于系统的文献综述和名义组技术（NGT）。由十人组成的科学委员会制定了八个临床相关问题。首先,进行了系统审查，以确定可用的证据，科学委员会根据他们的专业知识评估了这些建议，通过NGT达成共识。
结果：筛选了1673个标题和摘要，纳入43项研究符合纳入标准.科学委员会为开始使用HCQ提出了11项建议，维护,和监测,考虑HCQ的好处和潜在的不利影响。就所有建议达成一致。
结论：现有证据支持HCQ对SLE的有效性和安全性。对初始HCQ剂量的个性化评估很重要，特别是在需要减少剂量或停药的情况下。这种风险收益评估，特别关注视网膜毒性和SLE复发风险之间的平衡，应该指导关于停药的决定，考虑到疾病活动，危险因素，和HCQ的潜在好处。密切监测对于优化疾病管理和最小化潜在风险至关重要。如QT延长或视网膜毒性。
方法：使用的方法基于系统的文献综述和名义组技术（NGT）。由十人组成的科学委员会制定了八个临床相关问题。首先,进行了系统审查，以确定可用的证据，科学委员会根据他们的专业知识评估了这些建议，通过NGT达成共识。
结果：筛选了1673个标题和摘要，纳入43项研究符合纳入标准.科学委员会为开始使用HCQ提出了11项建议，维护,和监测,考虑HCQ的好处和潜在的不利影响。就所有建议达成一致。
结论：现有证据支持HCQ对SLE的有效性和安全性。对初始HCQ剂量的个性化评估很重要，特别是在需要减少剂量或停药的情况下。这种风险收益评估，特别关注视网膜毒性和SLE复发风险之间的平衡，应该指导关于停药的决定，考虑到疾病活动，危险因素，和HCQ的潜在好处。密切监测对于优化疾病管理和最小化潜在风险至关重要。如QT延长或视网膜毒性。
