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The impact of different algorithms for ideal body weight on screening for hydroxychloroquine retinopathy in women.

Browning DJ, Lee C, Rotberg D - Clin Ophthalmol (2014)

Bottom Line: Although hydroxychloroquine dosing should be based on the lesser of ABW and IBW, there is no consensus about the definition of IBW.The Michaelides algorithm is associated with the most frequent need to adjust dosing; the Metropolitan Life Insurance, large frame, mean value table with the least frequent need.No evidence indicates that one algorithm is superior to others.

View Article: PubMed Central - PubMed

Affiliation: Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, North Carolina, NC, USA.

ABSTRACT

Purpose: To determine how algorithms for ideal body weight (IBW) affect hydroxychloroquine dosing in women.

Methods: This was a retrospective study of 520 patients screened for hydroxychloroquine retinopathy. Charts were reviewed for sex, height, weight, and daily dose. The outcome measures were ranges of IBW across algorithms; rates of potentially toxic dosing; height thresholds below which 400 mg/d dosing is potentially toxic; and rates for which actual body weight (ABW) was less than IBW.

Results: Women made up 474 (91%) of the patients. The IBWs for a height varied from 30-34 pounds (13.6-15.5 kg) across algorithms. The threshold heights below which toxic dosing occurred varied from 62-70 inches (157.5-177.8 cm). Different algorithms placed 16%-98% of women in the toxic dosing range. The proportion for whom dosing should have been based on ABW rather than IBW ranged from 5%-31% across algorithms.

Conclusion: Although hydroxychloroquine dosing should be based on the lesser of ABW and IBW, there is no consensus about the definition of IBW. The Michaelides algorithm is associated with the most frequent need to adjust dosing; the Metropolitan Life Insurance, large frame, mean value table with the least frequent need. No evidence indicates that one algorithm is superior to others.

No MeSH data available.


Related in: MedlinePlus

Distribution of actual weights of 241 women taking hydroxychloroquine.
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f2-opth-8-1401: Distribution of actual weights of 241 women taking hydroxychloroquine.

Mentions: Seven algorithms used by ophthalmologists in screening for chloroquine and hydroxychloroquine retinopathy are listed in Table 1. Of the 474 women screened for hydroxychloroquine retinopathy, determinations of height, weight, and daily dose of drug were made in 269 (57%), 241 (51%), and 325 (69%), respectively. The distributions of height and weight are shown in Figures 1 and 2. The median height was 64 inches (162.6 cm), interquartile range (IQR) (62, 66 inches), range (57, 74 inches). The median weight was 160 pounds (72.7 kg), IQR (133, 185 pounds), range (90, 330 pounds). Twenty-nine percent of women were less than or equal to 63 inches tall (160 cm), a threshold height for potentially toxic dosing based on consumption of 400 mg hydroxychloroquine per day and a commonly used IBW algorithm.10 Twenty-seven percent of women weighed less than or equal to 135 pounds (61.4 kg), a threshold IBW for potentially toxic dosing based on consumption of 400 hydroxychloroquine per day. The daily doses used in order of frequency were 400 mg (192, 59.1%), 200 mg (106, 32.6%), 300 mg (25, 7.7%), 600 mg (1, 0.3%), and 150 mg (1, 0.3%). Of the 474 patients screened, 7 (1.5%) had hydroxychloroquine retinopathy.


The impact of different algorithms for ideal body weight on screening for hydroxychloroquine retinopathy in women.

Browning DJ, Lee C, Rotberg D - Clin Ophthalmol (2014)

Distribution of actual weights of 241 women taking hydroxychloroquine.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4116363&req=5

f2-opth-8-1401: Distribution of actual weights of 241 women taking hydroxychloroquine.
Mentions: Seven algorithms used by ophthalmologists in screening for chloroquine and hydroxychloroquine retinopathy are listed in Table 1. Of the 474 women screened for hydroxychloroquine retinopathy, determinations of height, weight, and daily dose of drug were made in 269 (57%), 241 (51%), and 325 (69%), respectively. The distributions of height and weight are shown in Figures 1 and 2. The median height was 64 inches (162.6 cm), interquartile range (IQR) (62, 66 inches), range (57, 74 inches). The median weight was 160 pounds (72.7 kg), IQR (133, 185 pounds), range (90, 330 pounds). Twenty-nine percent of women were less than or equal to 63 inches tall (160 cm), a threshold height for potentially toxic dosing based on consumption of 400 mg hydroxychloroquine per day and a commonly used IBW algorithm.10 Twenty-seven percent of women weighed less than or equal to 135 pounds (61.4 kg), a threshold IBW for potentially toxic dosing based on consumption of 400 hydroxychloroquine per day. The daily doses used in order of frequency were 400 mg (192, 59.1%), 200 mg (106, 32.6%), 300 mg (25, 7.7%), 600 mg (1, 0.3%), and 150 mg (1, 0.3%). Of the 474 patients screened, 7 (1.5%) had hydroxychloroquine retinopathy.

Bottom Line: Although hydroxychloroquine dosing should be based on the lesser of ABW and IBW, there is no consensus about the definition of IBW.The Michaelides algorithm is associated with the most frequent need to adjust dosing; the Metropolitan Life Insurance, large frame, mean value table with the least frequent need.No evidence indicates that one algorithm is superior to others.

View Article: PubMed Central - PubMed

Affiliation: Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, North Carolina, NC, USA.

ABSTRACT

Purpose: To determine how algorithms for ideal body weight (IBW) affect hydroxychloroquine dosing in women.

Methods: This was a retrospective study of 520 patients screened for hydroxychloroquine retinopathy. Charts were reviewed for sex, height, weight, and daily dose. The outcome measures were ranges of IBW across algorithms; rates of potentially toxic dosing; height thresholds below which 400 mg/d dosing is potentially toxic; and rates for which actual body weight (ABW) was less than IBW.

Results: Women made up 474 (91%) of the patients. The IBWs for a height varied from 30-34 pounds (13.6-15.5 kg) across algorithms. The threshold heights below which toxic dosing occurred varied from 62-70 inches (157.5-177.8 cm). Different algorithms placed 16%-98% of women in the toxic dosing range. The proportion for whom dosing should have been based on ABW rather than IBW ranged from 5%-31% across algorithms.

Conclusion: Although hydroxychloroquine dosing should be based on the lesser of ABW and IBW, there is no consensus about the definition of IBW. The Michaelides algorithm is associated with the most frequent need to adjust dosing; the Metropolitan Life Insurance, large frame, mean value table with the least frequent need. No evidence indicates that one algorithm is superior to others.

No MeSH data available.


Related in: MedlinePlus