Hydroxychloroquine and antiphospholipid antibody-related pregnancy morbidity: a systematic review and meta-analysis.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
pubmed:
18
7
2020
medline:
10
8
2021
entrez:
18
7
2020
Statut:
ppublish
Résumé
Pregnancies in women with antiphospholipid antibodies (aPL) are associated with several pregnancy complications. The current treatment to prevent obstetric aPL-mediated morbidity is largely based on low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH). Alternative treatment regimens to prevent obstetric aPL-related morbidity include the addition of the antimalarial hydroxychloroquine (HCQ). The aim of this systematic review is to identify the currently available evidence on the efficacy of HCQ to prevent aPL-related obstetric morbidity. We identified four retrospective observational studies. No definite signal of harm was identified as none of the studies reported adverse outcomes. When comparing a total of 214 aPL-positive women with a total of 250 HCQ-exposed aPL-positive pregnancies and 521 pregnancies not exposed to HCQ, we found that HCQ exposure was not associated with an increased rate of live births [pooled OR 1.33; 95% confidence interval (CI) 0.62--2.86]). There was considerable heterogeneity in the analysis (I = 59%). HCQ seems well tolerated in pregnancy. However, because of the heterogeneity of available studies, the questions whether women with aPL (or some subpopulation of those) might benefit from this agent during pregnancy remains unanswered. Randomized controlled data are needed.
Identifiants
pubmed: 32675702
doi: 10.1097/GCO.0000000000000649
pii: 00001703-202010000-00007
doi:
Substances chimiques
Antibodies, Antiphospholipid
0
Hydroxychloroquine
4QWG6N8QKH
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
351-358Références
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