title: Response to hydroxychloroquine in Japanese patients with lupus-related skin disease using the cutaneous lupus erythematosus disease area and severity index (CLASI).
abstract: BACKGROUND
  Hydroxychloroquine (HCQ) is not available in Japan. To design a clinical trial of HCQ, we evaluated the response to HCQ in Japanese patients with lupus-related skin disease using the cutaneous lupus erythematosus disease area and severity index (CLASI).
  
  
  METHODS
  Twenty-seven patients with lupus-related skin disease who started HCQ at four hospitals were included. Patients were categorized into responders by the CLASI response criteria. The points and the rate of improvement in the CLASI activity score after 16 weeks of treatment were analyzed, focusing on six parameters: systemic lupus erythematosus (SLE), skin manifestations, disease duration, prednisolone, smoking, and severity.
  
  
  RESULTS
  Twenty-seven patients, including 17 with SLE (6 with SLE/Sjögren's syndrome), were analyzed retrospectively. Twenty-three patients (85 %) were categorized as responders. The mean CLASI activity score improved from 10.1 to 4.5 (p < 0.0001). The improvement rate did not differ in these parameters except for that of annular erythema (81.6 versus 34.3 %, p = 0.036). On multivariate analysis, the baseline CLASI activity score (CLASI ≥9) correlated with the greatest decrease in CLASI activity score (F = 69.7, p < 0.0001).
  
  
  CONCLUSIONS
  CLASI is a reliable indicator to evaluate the efficacy of the drug, and HCQ is an effective treatment for Japanese patients with lupus-related skin disease.
authors.affiliation: Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan. yokogawan@aol.com
authors.forename: Naoto
authors.initials: N
authors.lastname: Yokogawa
authors.forename: Akiko
authors.initials: A
authors.lastname: Tanikawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Amagai
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kato
authors.forename: Yoko
authors.initials: Y
authors.lastname: Momose
authors.forename: Satoru
authors.initials: S
authors.lastname: Arai
authors.forename: Hikaru
authors.initials: H
authors.lastname: Eto
authors.forename: Takaharu
authors.initials: T
authors.lastname: Ikeda
authors.forename: Fukumi
authors.initials: F
authors.lastname: Furukawa
mesh_terms: D000293:Adolescent; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D044466:Asian People; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D007564:Japan; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine