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The impact of hydroxychloroquine on obstetric outcomes in refractory obstetric antiphospholipid syndrome

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dc.contributor.author Gerde, M.
dc.contributor.author Ibarra, E.
dc.contributor.author Mac Kenzie, Ronaldo
dc.contributor.author Fernández Suárez, C.
dc.contributor.author Heer, C.
dc.contributor.author Álvarez, R.
dc.contributor.author Iglesias, M.
dc.contributor.author Balparda, J.
dc.contributor.author Beruti, E.
dc.contributor.author Rubinstein, Fernando
dc.date.accessioned 2021-09-01T14:44:44Z
dc.date.available 2021-09-01T14:44:44Z
dc.date.issued 2021-08-12
dc.identifier.citation Gerde M, Ibarra E, Mac Kenzie R, Fernandez Suarez C, Heer C, Alvarez R, Iglesias M, Balparda J, Beruti E, Rubinstein F. The impact of hydroxychloroquine on obstetric outcomes in refractory obstetric antiphospholipid syndrome. Thromb Res. 2021 Aug 12;206:104-110. doi: 10.1016/j.thromres.2021.08.004 es_ES
dc.identifier.uri https://doi.org/10.1016/j.thromres.2021.08.004
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/565
dc.description.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. es_ES
dc.language.iso eng es_ES
dc.publisher Elsevier es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Hydroxychloroquine es_ES
dc.subject Hidroxicloroquina es_ES
dc.subject Antiphospholipid Syndrome es_ES
dc.subject Síndrome Antifosfolípido es_ES
dc.subject Obstetrics es_ES
dc.subject Obstetricia es_ES
dc.title The impact of hydroxychloroquine on obstetric outcomes in refractory obstetric antiphospholipid syndrome es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Gerde, M. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Ibarra, E. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Mac Kenzie, Ronaldo. Fleni. Servicio de Cardiología; Argentina.
dc.description.fil Fil: Fernández Suárez, C. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Heer, C. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Álvarez, R. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Iglesias, M. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Balparda, J. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Beruti, E. Hospital Universitario Austral; Argentina.
dc.description.fil Fil: Rubinstein, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina.
dc.relation.ispartofVOLUME 206
dc.relation.ispartofPAGINATION 104-110
dc.relation.ispartofCOUNTRY Estados Unidos
dc.relation.ispartofCITY Elmsford
dc.relation.ispartofTITLE Thrombosis research
dc.relation.ispartofISSN 1879-2472
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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