Obstetrical APS: Is there a place for hydroxychloroquine to improve the pregnancy outcome?

Arsene Mekinian, Nathalie Costedoat-Chalumeau, Agathe Masseau, Angela Tincani, Sara De Caroli, Jaume Alijotas-Reig, Amelia Ruffatti, Ales Ambrozic, Angela Botta, Véronique Le Guern, Ruth Fritsch-Stork, Pascale Nicaise-Roland, Bruno Carbonne, Lionel Carbillon, Olivier Fain

Research output: Contribution to journalReview articleResearchpeer-review

41 Citations (Scopus)

Abstract

© 2014 Elsevier B.V.. The use of the conventional APS treatment (the combination of low-dose aspirin and LMWH) dramatically improved the obstetrical prognosis in primary obstetrical APS (OAPS). The persistence of adverse pregnancy outcome raises the need to find other drugs to improve obstetrical outcome. Hydroxychloroquine is widely used in patients with various autoimmune diseases, particularly SLE. Antimalarials have many anti-inflammatory, anti-aggregant and immune-regulatory properties: they inhibit phospholipase activity, stabilize lysosomal membranes, block the production of several pro-inflammatory cytokines and, in addition, impair complement-dependent antigen-antibody reactions. There is ample evidence of protective effects of hydroxychloroquine in OAPS similar to the situation in SLE arising from in vitro studies of pathophysiological working mechanism of hydroxychloroquine. However, the clinical data on the use of hydroxychloroquine in primary APS are lacking and prospective studies are necessary.
Original languageEnglish
Pages (from-to)23-29
JournalAutoimmunity Reviews
Volume14
Issue number1
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • Antiphospholipid syndrome
  • Hydroxychloroquine
  • Outcome

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