Additional use of hydroxychloroquine increases live birth rates in women with persistently positive antiphospholipid antibodies

Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disorder defined as recurrent thrombotic and/or obstetric disease with persistent antiphospholipid antibody (aPL) positivity, including lupus anticoagulants, anti-beta-2 Glycoprotein I and/or anticardiolipin antibodies

In previous studies, treatment with low-dose aspirin and therapeutic-dose heparin in patients with APS was associated with higher live birth rates (mean 79% of pregnancies)

No teratogenic effects have been reported with the use of hydroxychloroquine during pregnancy

Recent in vitro and in vivo studies suggest that inflammatory processes may be responsible for obstetric complications in women with aPL

METHODS: From inception to 31 December 2019, a systematic search of the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases was performed

RESULTS: Five retrospective studies involving 477 pregnancies were selected

In conclusion, unlike other systematic reviews of pregnancy morbidity associated with hydroxychloroquine and antiphospholipid antibodies, data from this study suggest that receiving HCQ as add-on therapy improves live birth rates in pregnant women with persistent antiphospholipid antibodies

Reference: Tian Y, Xu J, Chen D, Yang C, Peng B.