Stopping Hydroxychloroquine in Elderly Lupus Patients

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Age ≥ 55 years at time of enrollment * Normal OCT and VF assessment within 6 months of screening visit * Ability to take oral medication * Have established SLE (≥ 4 ACR criteria or SLICC criteria or ≥ 10 points by EULAR criteria, SLE diagnosed at least seven years ago) * Stable disease at screening visit by attaining DORIS remission (meeting all criterion listed below) and not on any immunosuppressants. * Criterion 1: Clinical SLEDAI= 0 * Criterion 2: SELENA-SLEDAI PGA ≤ 0.5 (on a scale from 0-3, where 0 is no disease activity and 3 is maximum disease activity) * Criterion 3: Current prednisolone (or equivalent corticosteroid) dose ≤ 5 mg daily * No moderate or severe flares one year prior to screening * Taking ≥ 200 HCQ daily for ≥ 7 years Exclusion Criteria: * Any patient that does not attain stable disease status by DORIS * Ophthalmologic evidence of retinopathy (these patients would be advised to discontinue HCQ and therefore unethical to randomize for this study) * Clinical SLEDAI \> 0 * Taking \> 5 mg/day prednisone * Taking any immunosuppressive drugs or biological agents (including: methotrexate, azathioprine, mycophenolate mofetil, mycophenolic acid, leflunomide, cyclosporine, cyclophosphamide, tacrolimus, rituximab, and belimumab) * Any reason the treating rheumatologist is concerned about ongoing activity not captured by SLEDAI * HCQ level \< 100 ng/ml as this would support noncompliance and less reliance on HCQ to control activity * Patient unwilling or unable to comply with study procedures for any reason * Any indications of potentially diminished capacity, such as a diagnosis of dementia or cognitive impairment (including, but not limited to stroke-related cognitive impairment)