TY - JOUR
T1 - A Multidisciplinary Collaborative Approach to Retinal Toxic Effects Screening for Dermatology Patients Taking Antimalarials
AU - Fett, Nicole
AU - Werth, Victoria P.
N1 - Funding Information:
serving as an investigator for Lilly, Pfizer, and F. Hoffmann-La Roche and collects royalties from UpToDate outside the submitted work. Dr Werth reported serving as a consultant to Celgene, MedImmune, Resolve, Genentech, Idera, Janssen, Lilly, Pfizer, Biogen, Bristol Myers Squibb, Gilead, Amgen, Medscape, Nektar, Incyte, EMD Serono, CSL Behring, Principia, Crisalis, Viela Bio, Argenx, Kirin, Regeneron, AstraZeneca, AbbVie, Octapharma, GlaxoSmithKline, and AstraZeneca and receiving research support from Celgene, Janssen, Pfizer, Biogen, Gilead, Corvus Pharmaceuticals, Genentech, AstraZeneca, Viela Bio, and Syntimmune outside the submitted work, and through the University of Pennsylvania owns the copyright for the CLASI and CDASI.
Publisher Copyright:
© 2021 American Medical Association. All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Clinical Question: What are the roles of antimalarial therapy prescribers and eye care specialists in regard to antimalarial dosing, screening for retinal toxic effects, and antimalarial treatment cessation? Bottom Line: Antimalarial prescribers should prescribe antimalarial dosages at 5 mg/kg/d or less of actual body weight. A baseline retinal examination with optical coherence tomography should be performed within 6 months of starting antimalarial therapy to rule out confounding disease. Patients at low risk for retinopathy do not require annual screening until 5 years of antimalarial use. Eye care clinicians should not stop treatment with antimalarials because of equivocal findings, as retinopathy occurs slowly, and therefore there is time for repeated testing. Antimalarial treatment cessation should be a collaborative decision that involves the patient, the prescriber, and the eye care clinician and that focuses on patient values, the severity of the underlying disease, and the estimated risk of visual loss if treatment with the drug is continued..
AB - Clinical Question: What are the roles of antimalarial therapy prescribers and eye care specialists in regard to antimalarial dosing, screening for retinal toxic effects, and antimalarial treatment cessation? Bottom Line: Antimalarial prescribers should prescribe antimalarial dosages at 5 mg/kg/d or less of actual body weight. A baseline retinal examination with optical coherence tomography should be performed within 6 months of starting antimalarial therapy to rule out confounding disease. Patients at low risk for retinopathy do not require annual screening until 5 years of antimalarial use. Eye care clinicians should not stop treatment with antimalarials because of equivocal findings, as retinopathy occurs slowly, and therefore there is time for repeated testing. Antimalarial treatment cessation should be a collaborative decision that involves the patient, the prescriber, and the eye care clinician and that focuses on patient values, the severity of the underlying disease, and the estimated risk of visual loss if treatment with the drug is continued..
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U2 - 10.1001/jamadermatol.2021.2699
DO - 10.1001/jamadermatol.2021.2699
M3 - Review article
C2 - 34319351
AN - SCOPUS:85111882613
VL - 157
SP - 1112
EP - 1113
JO - A. M. A. archives of dermatology and syphilology
JF - A. M. A. archives of dermatology and syphilology
SN - 2168-6068
IS - 9
ER -