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Solving the Hydroxychloroquine Dosing Dilemma With a Smartphone App

2018; American Medical Association; Volume: 136; Issue: 2 Linguagem: Inglês

10.1001/jamaophthalmol.2017.6076

2168-6173

Elliot M Perlman, Paul B. Greenberg, David J. Browning, Robert P. Friday, Joan W. Miller,

Retinoids in leukemia and cellular processes

Solving the Hydroxychloroquine Dosing Dilemma With a Smartphone AppHydroxychloroquine retinopathy (HCR) is a potentially blinding disease.Once HCR is detected, there is no treatment and the disease often continues to progress, even when the medication is stopped.Hence, primary prevention by appropriate dosing of hydroxychloroquine offers the best chance of minimizing the risk of HCR.This strategy remains challenging in practice as up to 56% of patients receive hydroxychloroquine at doses that place them at higher risk for HCR. 1 A key reason is disagreement in how to calculate dosages of hydroxychloroquine. 2,3There are 2 methods: one uses ideal body weight (IBW); the other uses actual body weight (ABW).The IBW method assumes that hydroxychloroquine is stored mostly in lean tissue. 2 The daily dose must be normalized by lean body mass.This makes the calculation more complicated than the ABW method, which assumes that the drug is distributed evenly in muscle, skin, and fat. 3 We describe a free smartphone app-DoseCheckerthat can rapidly calculate the optimal weekly dose of hydroxychloroquine using elements of both methods. Methods |The code for the DoseChecker app was written by one of us (E.M.P.) using the smartBASIC app.SmartBASIC provides an XCode shell for a Basic interpreter and the interpreter is then used to generate an app compatible with the iOS operating system.Massachusetts Eye and Ear became the Apple Developer for the app on May 4, 2017.The app became available in the App Store on September 10, 2017. ABW Method.Maximum Daily Dose = 5 (mg/kg/d) × ABW (kg) IBW Method.The National Lung and Blood Institute formula is expressed in pounds: IBW (lb) = 4.28 × Height (in) -134.32.It is then converted to kilograms.