The Role of Hydroxychloroquine Treatment on Pregnancy Outcome in Women with Antiphospholipid Antibodies

Savino Sciascia¹, Beverely J Hunt², Eva Talavera-Garcia³, Gloria Lliso³, Munther Khamashta³ and Mª Jose Cuadrado⁴, ¹Department of Rare, Immunologic, Hematologic and Immunohematologic Diseases, Centro di Immunopatologia e Documentazione su Malattie rare, Torino, Italy, ²Thrombosis & Haemostasis, Guy’s & St Thomas’ NHS Foundation Trust, London, UK, London, United Kingdom, ³Louise Coote Lupus Unit, Guy’s and St Thomas’ NHS Foundation Trust, London, UK, London, United Kingdom, ⁴Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, London, United Kingdom

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Antiphospholipid antibodies, antiphospholipid syndrome, hydroxychloroquine and pregnancy

Session Information

Date: Tuesday, November 10, 2015

Title: Antiphospholipid Syndrome: Clinical

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: With good management, around 70% of pregnant women with Antiphospholipid Syndrome (APS) will deliver a viable live infant.However, current management does not prevent all maternal, foetal and neonatal complications of APS. This observational, retrospective, single-centre cohort study aimed to assess pregnancy outcome in women with antiphospholipid antibody(aPL) treated with hydroxychloroquine (HCQ) in addition to conventional treatment during pregnancy.

Methods: One-hundred and seventy pregnancies in 96 women with persistent aPL were analysed:51 pregnancies occurred in 31 women treated with HCQ for at least six months prior to pregnancy and continued throughout gestation(group A);119 pregnancies occurred in 65 women with aPL not treated with HCQ were included as controls (group B).

Results: HCQ-treatment was associated with a higher rate of live births (67%groupA vs. 57% group B,p=0.05)and a lower prevalence of aPL-related pregnancy morbidity (47% group A vs. 63% B,p=0.004).The association of HCQ with the absence of any complication in pregnancy was confirmed after multivariate analysis (OR 2.2;95%CI 1.2-136;p=0.04). Fetal losses>10^thweeks of gestation(2% vs. 11%,p=0.05)and placenta mediated complications (2% vs 11%,p=0.05)were less frequent in group A than B.Pregnancy duration was longer in group A than B(27.6 [6-40] vs. 21.5[6-40] weeks,p=0.03).There was a higher rate of spontaneous vaginal labour in HCQ-treated women compared to group B(37.3% vs. 14.3%,p=0.01).

Conclusion: Despite the heterogeneity in the two groups in terms of SLE prevalence and previous pregnancy history, our results support the concept that women with aPL may benefit from treatment with HCQ during pregnancy to improve pregnancy outcome.The addition of HCQ to conventional treatment is worthy of further assessment.

Disclosure: S. Sciascia, None; B. J. Hunt, None; E. Talavera-Garcia, None; G. Lliso, None; M. Khamashta, None; M. J. Cuadrado, None.

To cite this abstract in AMA style:

Sciascia S, Hunt BJ, Talavera-Garcia E, Lliso G, Khamashta M, Cuadrado MJ. The Role of Hydroxychloroquine Treatment on Pregnancy Outcome in Women with Antiphospholipid Antibodies [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-role-of-hydroxychloroquine-treatment-on-pregnancy-outcome-in-women-with-antiphospholipid-antibodies/. Accessed .

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