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

Arsène Mekinian, Maria Grazia Lazzaroni, Anna Kuzenko, Jaume Alijotas-Reig, Amelia Ruffatti, Pierre Levy, Valentina Canti, Katarina Bremme, Holy Bezanahary, Tiziana Bertero, Robin Dhote, Francois Maurier, Laura Andreoli, Amélie Benbara, Ahmed Tigazin, Lionel Carbillon, Pascale Nicaise-Roland, Angela Tincani, Olivier Fain

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105 Citations (Scopus)

Abstract

© 2015 Elsevier B.V. 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 (400. mg 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.
Original languageEnglish
Pages (from-to)498-502
JournalAutoimmunity Reviews
Volume14
Issue number6
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • Hydroxychloroquine
  • Obstetrical antiphospholipid syndrome
  • Outcome

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