What is your approach for severe SCLE in patients unable to tolerate HCQ?
Answer from: at Community Practice
30% of subacute cutaneous lupus erythematosus (SCLE) is worsened by or caused by drugs, especially PPIs, calcium channel blockers (CCBs), thiazides, minocycline, and anti-fungal meds. Very different from other drug-induced disorders, the culprit drug could have been started months to years (as lon...
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at Bryn Mawr Medical Specialists Association Thank you for your response. What has been your ex...
at Uniformed Services University of the Health Sciences (USUHS) @Jay K. Ghadiali: Most insurance won't cover them,...
at Rheumatology Associates of Long Island I did identify a local pharmacy in New York (Lond ...
at Uniformed Services University of the Health Sciences (USUHS) Thanks! I'll add that to my list, @Howard Blumstei...
at Northwestern University Your responses are always so thoughtful and thorou...
at Uniformed Services University of the Health Sciences (USUHS) Thanks, @Deirdre De Ranieri! I love this format. I...
I would make sure they are not taking a drug that could cause SCLE, like omeprazole or another PPI. You could try methotrexate or mycophenolate mofetil. Anifrolumab would probably work but is hard to get unless the patient has SLE. Lenalidomide is a thalidomide derivative that works well for very re...
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at Arthritis Associates Another medication that I have seen help some SCLE...
I have found that adding 15-25 mg/week sc Methotrexate works very well for SCLE that is insufficiently responsive to HCQ or for patients unable to take HCQ. Failing that, anifrolumab provided the patient has sufficient SLE criteria to access it.
With regard to HCQ intolerance, whether it be GI into...
Thank you for your response. What has been your ex...
@Jay K. Ghadiali: Most insurance won't cover them,...
I did identify a local pharmacy in New York (Lond ...
Thanks! I'll add that to my list, @Howard Blumstei...
Your responses are always so thoughtful and thorou...
Thanks, @Deirdre De Ranieri! I love this format. I...