Non‐adherence to hydroxychloroquine in systemic lupus erythematosus: The elephant in the clinic room.

This article discusses the use of hydroxychloroquine (HCQ) in the treatment of systemic lupus erythematosus (SLE). HCQ has been shown to have multiple benefits in reducing SLE activity, preventing flares, and reducing the severity of lupus nephritis. However, non-adherence to HCQ is a major concern for patients, with up to 83% of SLE patients reporting intermittent or persistent non-adherence. Studies have shown that low HCQ levels are associated with higher disease activity and increased risk of flares. On the other hand, higher HCQ levels have been associated with toxicities such as skin hyperpigmentation and retinopathy. The article suggests that routine measurement of HCQ levels may help identify non-adherence and stratify patients at risk of toxicities. Better communication, patient education, reminders, and regular surveillance of drug adherence may help improve adherence and treatment outcomes. [Extracted from the article]