Cargando…

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

OBJECTIVE: To investigate the effect of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE). METHODS: 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 Activ...

Descripción completa

Detalles Bibliográficos
Autores principales: Kroese, S. J., de Hair, M. J. H., Limper, M., Lely, A. T., van Laar, J. M., Derksen, R. H. W. M., Fritsch-Stork, R. D. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748114/
https://www.ncbi.nlm.nih.gov/pubmed/29392142
http://dx.doi.org/10.1155/2017/2810202
_version_ 1783289360790061056
author Kroese, S. J.
de Hair, M. J. H.
Limper, M.
Lely, A. T.
van Laar, J. M.
Derksen, R. H. W. M.
Fritsch-Stork, R. D. E.
author_facet Kroese, S. J.
de Hair, M. J. H.
Limper, M.
Lely, A. T.
van Laar, J. M.
Derksen, R. H. W. M.
Fritsch-Stork, R. D. E.
author_sort Kroese, S. J.
collection PubMed
description OBJECTIVE: To investigate the effect of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE). METHODS: 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. RESULTS: 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)). CONCLUSION: HCQ use was associated with longer pregnancy duration in the vulnerable preterm birth population, underscoring the beneficial effect of HCQ use during pregnancy.
format Online
Article
Text
id pubmed-5748114
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-57481142018-02-01 Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births Kroese, S. J. de Hair, M. J. H. Limper, M. Lely, A. T. van Laar, J. M. Derksen, R. H. W. M. Fritsch-Stork, R. D. E. J Immunol Res Research Article OBJECTIVE: To investigate the effect of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE). METHODS: 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. RESULTS: 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)). CONCLUSION: HCQ use was associated with longer pregnancy duration in the vulnerable preterm birth population, underscoring the beneficial effect of HCQ use during pregnancy. Hindawi 2017 2017-12-17 /pmc/articles/PMC5748114/ /pubmed/29392142 http://dx.doi.org/10.1155/2017/2810202 Text en Copyright © 2017 S. J. Kroese et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kroese, S. J.
de Hair, M. J. H.
Limper, M.
Lely, A. T.
van Laar, J. M.
Derksen, R. H. W. M.
Fritsch-Stork, R. D. E.
Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title_full Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title_fullStr Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title_full_unstemmed Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title_short Hydroxychloroquine Use in Lupus Patients during Pregnancy Is Associated with Longer Pregnancy Duration in Preterm Births
title_sort hydroxychloroquine use in lupus patients during pregnancy is associated with longer pregnancy duration in preterm births
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748114/
https://www.ncbi.nlm.nih.gov/pubmed/29392142
http://dx.doi.org/10.1155/2017/2810202
work_keys_str_mv AT kroesesj hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT dehairmjh hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT limperm hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT lelyat hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT vanlaarjm hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT derksenrhwm hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths
AT fritschstorkrde hydroxychloroquineuseinlupuspatientsduringpregnancyisassociatedwithlongerpregnancydurationinpretermbirths