Do you ever consider discontinuing hydroxychloroquine in patients with SLE in longstanding remission except in cases of overt toxicity?  

I’ll assume that this question is only for SLE patients who are tolerating it well, have been in remission, and are not on steroids or other immunosuppressants (since hydroxychloroquine, HCQ, is safer than all of these).Since very few things in medicine are 100%, the answer must be “yes....

As treatments improve and patients live longer, this becomes an important clinical question. I would certainly consider discontinuing HCQ (and have done it in the past after a careful discussion and documentation of potential risks and benefits with the patient). This seems like a much safer option ...