Evaluation of adverse events triggered by the use of chloroquine diphosphate, emphasis on retina toxicity, in 350 patients with lupus erythematosus

Abstract

BACKGROUND - The occurrence of antimalarial retinopathy is reducing all over the world, but are few brazilian studies. OBJECTIVES - Analysis of the occurrence of adverse effects, triggered by use of 250mg/d of chloroquine diphosphate in 350 patients with for lupus erythematosus. METHODS - Review of clinical records and analysis between adverse effects and the daily dose per kg, age and the differents types of lupus erythematosus; and the periodicity of ophthalmologic screening. RESULTS - 35,7% of adverse effects, ocular toxicity (17,4%): retinal pigmentation suggestive of antimalarial retinopathy (12%), corneal deposits (3,1%) and acute visual symptoms(2,3%); gastrointestinal (10%), cutaneous (3,4%), headache (2,9%), neuromuscular (1,7%) and psychiatric (0,3%). Antimalarial retinopathy confirmed in 2,6%. No statistically significant association between occurrence of adverse effects and retinotoxicity with the daily dose per kg and the type of lupus erythematosus. Retinotoxicity was statistically significant (p=0,004) in patients over 50 years. Ophthalmologic screening was conducted on average after 10,5 months. CONCLUSIONS - Antimalarial retinopathy occurred in 2,6% of the patients. Ophthalmologic screening had to be more careful in patients over 50 years because the difficulty to differentiate between initial antimalarial retinopathy and senile macular degeneration. ©2005 by Anais Brasileiros de Dermatologia.