Reaction of Chloroquine in Rheumatic Patients at Maharat Nakhon Ratchasima Hospital

Abstract

Introduction: Chloroquine is commonly used and effective in treatment of Rheumatoid arthritis, SLE and other connective tissue diseases. Chloroquine acts as disease modifying antirheumatic drugs (DMARDS) in treatment of Rheumatoid arthritis, alleviates arthritis and photosensitivity rash in SLE. It has low cost, once-a day dosage used and less toxicity but the most serious side effect is retinopathy, though rarely occurred. Chloroquine-induced retinopathy can cause permanent visual loss. Objective: To study adverse effects of chloroquine including retinopathy patients. Optimal and safe dose of drug per day in Rheumatic patients of Maharat Nakhon Ratchasima Hospital. Method: Retrospective study from Medical records in Rheumatic clinic at Maharat Nakhon Ratchasima Hospital during October 1997 to May 2001 was performed. All the patients were prescribed chlorowuine 1-2 tab(s) day. Results: 123 patients were recruited, 105 females and 18 males. The diagnoses were 73 RA, 49 SLE and 1 MCTD. There were 20 events of side effect occurring in 18 patients (2 patients with 2 side effects), 9 with eye problems, 7 with headache and dizziness. 3 with skin problems and 1 patient having abdominal pain. In the group of eye problems, the eye examination revealed 3 visual field defect, 5 maculopathy and no data of eye examination for one patient. These side effects were recognized between 5 to 44 months, they were completely recovered after appropriate management without chloroquine withdrawal. Conclusion: Cholrquine is still a useful drug with low incidence of retinopathy, 7.3% found in this study. Every patient who has to receive chloro2uine should be regularly performed fundoscopic examination. The best awareness of retinopothy is to monitor blur eye symptom every follow up. The patients must be sen to ophthalmologist for eye check up once or twice a year.