| dc.contributor.author | Gerde, M. | |
| dc.contributor.author | Ibarra, E. | |
| dc.contributor.author | Balparda, J. | |
| dc.contributor.author | Et al. | |
| dc.date.accessioned | 2023-11-13T13:09:31Z | |
| dc.date.available | 2023-11-13T13:09:31Z | |
| dc.date.issued | 2021-10 | |
| dc.identifier.citation | Thromb Res . 2021 Oct:206:104-110 | es |
| dc.identifier.issn | 0049-3848 | |
| dc.identifier.uri | https://riu.austral.edu.ar/handle/123456789/2383 | |
| dc.description | Disponible en: https://www.thrombosisresearch.com/article/S0049-3848(21)00422-9/fulltext | es |
| dc.description.abstract | Abstract
Background: The use of low-dose aspirin (LDA) and heparin has improved pregnancy outcomes in women with antiphospholipid syndrome (APS). However, 20-30% still have adverse outcomes despite treatment. Recent retrospective studies showed a beneficial effect of hydroxychloroquine (HCQ) in APS due to its anti-inflammatory, immunomodulatory and antithrombotic properties. Data in refractory obstetric APS (OAPS) remain scarce and include heterogeneous populations with various concomitant treatments.
Objective: The objective of this study was to assess the impact on the obstetric outcomes of adding HCQ to classical treatments for women with refractory primary obstetric APS.
Methods: In a retrospective single-centre cohort study, we compared pregnancy outcomes in women with refractory primary OAPS (2004-2019) who received two different treatments in subsequent pregnancies. Group A received 400 mg HCQ + 60 mg enoxaparin + LDA, while Group B received 60 mg enoxaparin + LDA. The main outcome was live birth rates, while pregnancy complications (early and late pregnancy losses and placental-mediated complications) were the secondary outcome.
Results: A total of 101 pregnancies in 87 refractory primary OAPS patients were included. The rate of live-born babies in Group A (HCQ) was 97.1% (67/69) vs. 62.5% (20/32) in Group B (RR: 1.55 [95% CI, 1.19-2.1]; p < 0.001). Pregnancy complications in Group A were 8.7% (6/69) vs. 37.5% (12/32) in Group B (RR 0.22 [95% CI, 0.15-0.30]; p < 0.001).
Conclusion: Hydroxychloroquine was associated with a higher rate of live births and a lower prevalence of pregnancy complications in refractory primary obstetric APS. The addition of HCQ to classical treatment may present a promising approach that needs to be confirmed with prospective studies.
Keywords: APS treatment; Antiphospholipid syndrome; Enoxaparin; Hydroxychloroquine; Pregnancy complications; Refractory obstetric APS.
Copyright © 2021 Elsevier Ltd. All rights reserved. | es |
| dc.language.iso | en | es |
| dc.publisher | Elsevier | es |
| dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
| dc.subject | APS treatment | es |
| dc.subject | Antiphospholipid syndrome | es |
| dc.subject | Enoxaparin | es |
| dc.title | The impact of hydroxychloroquine on obstetric outcomes in refractory obstetric antiphospholipid syndrome | es |
| dc.type | Article | es |
