Is Hydroxychloroquine Safe for Patients with G6PD Deficiency?

There is no data to support the withholding of hydroxychloroquine (HCQ) therapy among African American patients with glucose-6-phosphate dehydrogenase (G6PD), according to the results of a recent review.

The researchers conducted a retrospective chart review that included 275 patients with a measured G6PD and HCQ usage (84% of patients were female and 46% were African American).
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Of the 275 patients, 32% were diagnosed with lupus, 29% with rheumatoid arthritis, and 14% with inflammatory arthritis. Only 4% of patients were G6PD deficient, all of which were African American.

Overall, there were no incidents of hemolysis reported in over 700 months of HCQ exposure among the 11 G6PD-deficient patients. Two G6PD-deficient patients experienced hemolysis during severe lupus flares that occurred while not taking HCQ.

“This is the largest study to date evaluating G6PD deficiency with concurrent use of HCQ,” the researchers concluded. “These data do not support routine G6PD level measurement or withholding HCQ therapy among African American patients with G6PD deficiency.”

—Melissa Weiss

Reference:

Mohammad S, Clowse MEB, Eudy AM, and Criscione-Schreiber LG. Hydroxychloroquine is not associated with hemolytic anemia in glucose-6-phosphate dehydrogenase (G6PD) deficient patients [published online May 26, 2017]. Arthritis Care Res. doi:10.1002/acr.23296.