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Autoimmun Rev. 2015 Jun;14(6):498-502. doi: 10.1016/j.autrev.2015.01.012. Epub 2015 Jan 21.

The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: Data from a European multicenter retrospective study.

Author information

1
AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, F-75012 Paris, France. Electronic address: arsene.mekinian@sat.aphp.fr.
2
Rheumatology and Clinical Immunology, Department of Clinical and Experimental Sciences, University and Spedali Civili of Brescia, Brescia, Italy.
3
Clinical Immunology AO Ordine Mauriziano, Turin, Italy.
4
Systemic Autoimmune Disease Unit, Department of Internal Medicine I, Vall d'Hebrón University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain.
5
Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
6
Département de Santé Publique, Hôpitaux Universitaires de l'Est Parisien (Tenon), Paris, France; Inserm U 1136, Paris, France; Université Pierre et Marie Curie UMR S 1136, Paris, France.
7
Istituto Scientifico Ospedale San Raffaele, Milano, Italy.
8
Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden.
9
Université de Limoges, Limoges, France; Service de Médecine Interne, Hôpital Limoges, Limoges, France.
10
Université Paris 13, Bobigny, France; AP-HP, Service de Médecine Interne, Hôpital Avicenne, 93000 Bobigny, France.
11
Service de Médecine Interne, HPMetz Site Belle Isle, Metz, France.
12
Université Paris 13, Bondy, France; AP-HP, Service de Gynécologie-Obstétrique, Hôpital Jean Verdier, 93140 Bondy, France.
13
AP-HP, Autoimmunité et Hypersensibilité, Hopital Bichat, Paris, France.
14
AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne, Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, F-75012 Paris, France.

Abstract

In European multicenter study, we aimed to describe the real-life hydroxychloroquine use in APS patients during pregnancy and determine its benefit in refractory obstetrical APS. We analyzed the outcome of pregnancies treated by hydroxychloroquine in patients with APS or asymptomatic antiphospholipid (aPL) antibodies carriers. Thirty patients with APS with 35 pregnancies treated by hydroxychloroquine were analyzed. Comparing the outcome of pregnancies treated by the addition of hydroxychloroquine to previous pregnancies under the conventional treatment, pregnancy losses decreased from 81% to 19% (p<0.05), without differences in the associated treatments. The univariate analysis showed that the previous intrauterine deaths and higher hydroxychloroquine amount (400mg per day) were the factors associated with pregnancy outcome. Considering 14 patients with previous refractory obstetrical APS (n=5 with obstetrical and thrombotic primary APS and n=9 with purely obstetrical APS), all with previous pregnancy losses under treatment (aspirin with LMWH in 11 cases and LMWH in 3 cases), the addition of hydroxychloroquine resulted in live born babies in 11/14 (78%) cases (p<0.05). Our study shows the benefit of hydroxychloroquine addition in patients with refractory obstetrical APS and raises the need of prospective studies to confirm our preliminary study.

KEYWORDS:

Hydroxychloroquine; Obstetrical antiphospholipid syndrome; Outcome

PMID:
25617818
DOI:
10.1016/j.autrev.2015.01.012
[Indexed for MEDLINE]

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