Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births

Journal of Immunology Research
S J KroeseR D E Fritsch-Stork

Abstract

To investigate the effect of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE). In SLE pregnancies of a single Dutch center (2000-2015), lupus activity and flares before and during pregnancy and postpartum were assessed using the SLE Disease Activity Index (SLEDAI)/SLEPDAI (SLEDAI adjusted for pregnancy). The association between HCQ use and pregnancy outcomes (early spontaneous abortion, fetal death, and preterm and term live birth) was analyzed using generalized estimating equations (GEE) accounting for the occurrence of multiple pregnancies per patient. Analyses were adjusted for antiphospholipid antibody (aPL) status. 110 pregnancies (63 mostly Caucasian patients) were included, of which, in 30, HCQ was used; overall occurrence of flares was low (non-HCQ group: 5 mild (6.4%) and 2 severe (2.6%); HCQ group: 2 mild (6.7%) and no severe flares). The HCQ group showed a trend towards lower dosage of prednisone (OR 0.2 (95% CI 0.0-1.4); p = 0.10). Pregnancy outcomes were comparable between groups. Among preterm live births, pregnancy duration was significantly longer in HCQ users (2.4 weeks (95% CI 1.0-3.8; p ≤ 0.001)). HCQ use was associated with longer pregnancy duration in the vulnerable preterm...Continue Reading

References

Feb 1, 1996·British Journal of Rheumatology·G Ruiz-IrastorzaN M Buchanan
Jul 1, 1996·Annals of the Rheumatic Diseases·N M BuchananG R Hughes
Nov 24, 1999·Lupus·J P BuyonM Khamashta
Aug 3, 2004·Pediatrics·Marvin L WangElizabeth A Catlin
Nov 1, 2006·Arthritis and Rheumatism·Megan E B ClowseMichelle Petri
May 6, 2008·American Journal of Obstetrics and Gynecology·Megan E B ClowseAndra H James
Jun 23, 2015·Annals of Internal Medicine·Jill P BuyonJane E Salmon
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Dec 25, 2015·British Journal of Clinical Pharmacology·Yusuf Cem KaplanGideon Koren

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Citations

May 17, 2018·Expert Review of Clinical Immunology·Gabriella Moroni, Claudio Ponticelli
Dec 19, 2018·Journal of Clinical Medicine·Claudio Ponticelli, Gabriella Moroni
Apr 1, 2020·International Journal of Rheumatic Diseases·Miguel Ángel SaavedraLuis Javier Jara
Dec 1, 2020·Revista brasileira de ginecologia e obstetrícia : revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia·Rahana Abd RahmanAni Amelia Zainuddin
Jun 6, 2018·Current Opinion in Rheumatology·Amaia UgarteGuillermo Ruiz-Irastorza

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Methods Mentioned

BETA
SGA

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