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. 2014 Jul 24:8:1401-7.
doi: 10.2147/OPTH.S66531. eCollection 2014.

The impact of different algorithms for ideal body weight on screening for hydroxychloroquine retinopathy in women

David J Browning  1 , Chong Lee  1 , David Rotberg  1
Affiliations

The impact of different algorithms for ideal body weight on screening for hydroxychloroquine retinopathy in women

David J Browning et al. Clin Ophthalmol. .

Abstract

Purpose: To determine how algorithms for ideal body weight (IBW) affect hydroxychloroquine dosing in women.

Methods: This was a retrospective study of 520 patients screened for hydroxychloroquine retinopathy. Charts were reviewed for sex, height, weight, and daily dose. The outcome measures were ranges of IBW across algorithms; rates of potentially toxic dosing; height thresholds below which 400 mg/d dosing is potentially toxic; and rates for which actual body weight (ABW) was less than IBW.

Results: Women made up 474 (91%) of the patients. The IBWs for a height varied from 30-34 pounds (13.6-15.5 kg) across algorithms. The threshold heights below which toxic dosing occurred varied from 62-70 inches (157.5-177.8 cm). Different algorithms placed 16%-98% of women in the toxic dosing range. The proportion for whom dosing should have been based on ABW rather than IBW ranged from 5%-31% across algorithms.

Conclusion: Although hydroxychloroquine dosing should be based on the lesser of ABW and IBW, there is no consensus about the definition of IBW. The Michaelides algorithm is associated with the most frequent need to adjust dosing; the Metropolitan Life Insurance, large frame, mean value table with the least frequent need. No evidence indicates that one algorithm is superior to others.

Keywords: actual body weight; algorithms; hydroxychloroquine; ideal body weight; retinopathy; toxicity.

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Figures

Figure 1
Figure 1
Distribution of heights of 269 women taking hydroxychloroquine.
Figure 2
Figure 2
Distribution of actual weights of 241 women taking hydroxychloroquine.
Figure 3
Figure 3
Graphs of ideal body weight versus height for seven algorithms used in ophthalmology publications concerning screening for hydroxychloroquine retinopathy. Abbreviation: NHLBI, National Heart Lung and Blood Institute.
See this image and copyright information in PMC

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