Almeida-Brasil CC, Hanly JG, Urowitz M, et al. - In systemic lupus erythematosus (SLE) patients, a higher flare risk was observed after hydroxychloroquine (HCQ) taper/discontinuation vs HCQ maintenance. Decisions to maintain, decrease or stop HCQ could impact particular subgroups differently, including those on prednisone and/or with low education.

• From the Systemic Lupus International Collaborating Clinics cohort, a total of 1,460 SLE patients (90% female) initiating HCQ were analyzed to assess SLE flares after HCQ reduction or discontinuation vs HCQ maintenance.

• For HCQ reduction and discontinuation groups, adjusted HRs (aHRs) for first SLE flare were 1.20 and 1.56, respectively, vs HCQ maintenance.

• Particularly, a risk of flaring post-HCQ discontinuation was present in patients with low educational level (aHR 1.43).

• Prednisone use at time-zero was found to be related to over 1.5-fold elevation in flare risk in all HCQ subcohorts.