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Hydroxychloroquine Retinopathy — SCE Rheumatology MCQ

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HardRheumatology PharmacologyHydroxychloroquine RetinopathySCE Rheumatology

A patient with active lupus nephritis starts voclosporin 23.7 mg twice daily. Two repeat measurements confirm an eGFR fall of 24% from baseline; eGFR remains below 60 mL/min/1.73 m². What adjustment follows the UK SmPC?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Reduce by 7.9 mg twice daily; repeat eGFR within 2 weeks

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

A is correct. A confirmed eGFR reduction greater than 20% but below 30% requires a reduction of one 7.9 mg capsule from both the morning and evening doses, followed by reassessment within two weeks. A fall of 30% or more requires interruption; a fall of 20% or less is monitored without adjustment. The rule is based on percentage change from the patient’s baseline, not on conversion to another calcineurin inhibitor.

Reference: Lupkynis 7.9 mg soft capsules SmPC: https://www.medicines.org.uk/emc/product/14381/smpc