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Chloroquine Levels in Blood During Chronic Treatment of Patients with Rheumatoid Arthritis

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Specialty Pharmacology
Date 1992 Jan 1
PMID 1307690
Citations 43
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Abstract

Blood levels of racemic chloroquine and its main metabolites desethylchloroquine and bisdesethylchloroquine were measured in 29 patients treated chronically for rheumatoid arthritis. In six patients, the concentrations were followed during a one day dosage interval. There was considerable intersubject variability in the steady state blood concentrations of chloroquine (range 36.6 to 3895 ng.ml-1) and its two main biotransformation products; the latter represented, respectively, 47.7% and 12.9% of the concentration of chloroquine. This finding shows the need for further studies in view of the known toxic effects of chloroquine and the inevitable accumulation due to the exceptionally long residence time of the compound and its metabolites. The main requirement, which has not yet been met, for adding chloroquine to the list of drugs for which therapeutic drug monitoring is useful, is the lack of information about its mechanism of action, and consequently the dose-effect relationships of its therapeutic and toxic actions. Regular ophthalmic examination, in particular, is strongly recommended. The relatively high concentrations of desethylchloroquine and bisdesethylchloroquine found during chronic treatment show the need for more information about the therapeutic value and adverse effects of the metabolites.

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References
1.
Essien E, Ette E, THOMAS W, Brown-Awala E . Chloroquine disposition in hypersensitive and non-hypersensitive subjects and its significance in chloroquine-induced pruritus. Eur J Drug Metab Pharmacokinet. 1989; 14(1):71-7. DOI: 10.1007/BF03190844. View

2.
Ofori-Adjei D, Ericsson O, Lindstrom B, Sjoqvist F . Protein binding of chloroquine enantiomers and desethylchloroquine. Br J Clin Pharmacol. 1986; 22(3):356-8. PMC: 1401130. DOI: 10.1111/j.1365-2125.1986.tb02900.x. View

3.
LAAKSONEN A, Koskiahde V, JUVA K . Dosage of antimalarial drugs for children with juvenile rheumatoid arthritis and systemic lupus erythematosus. A clinical study with determination of serum concentrations of chloroquine and hydroxychloroquine. Scand J Rheumatol. 1974; 3(2):103-8. DOI: 10.3109/03009747409115809. View

4.
Walker O, Birkett D, Alvan G, Gustafsson L, Sjoqvist F . Characterization of chloroquine plasma protein binding in man. Br J Clin Pharmacol. 1983; 15(3):375-7. PMC: 1427768. DOI: 10.1111/j.1365-2125.1983.tb01513.x. View

5.
Rynes R . Antimalarial treatment of rheumatoid arthritis: 1985 status. J Rheumatol. 1985; 12(4):657-9. View