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CME Evaluation

Oral Communication Session

Women's Hemostasis and Thrombosis

Session: Thrombotic complications in pregnancy

OC 31.2 - Hydroxychloroquine Treatment for Improving Pregnancy Outcomes in Patients with Antiphospholipid Syndrome: A Systematic Review and Meta-Analysis

Monday, June 24, 2024
09:45 – 10:00 ICT
Room: Ballroom B1

    Co-Author(s)

  • AB

    Aya Berman

    Family medicine intern
    Dan Petah-Tikvah District at Clalit Health Services, Israel
    Hod hasharon, HaMerkaz, Israel

  • SS

    Shelly Soffer

    Internal Medicine doctor
    Internal Medicine B, Assuta Medical Center, Ashdod, Israel
    Ashdod, HaDarom, Israel

  • GK

    Gili Kenet

    CONSULTANT PAEDIATRIC HAEMATOLOGIST
    National Hemophilia Center Sheba Medical center, Tel Hashomer & Amalia Biron Research Institute of Thrombosis & Hemostasis, Tel Aviv University, Israel,
    Tel Aviv, Tel Aviv, Israel

  • AL

    Aharon Lubetsky

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel
    Ramat Gan, HaMerkaz, Israel

  • AA

    Assaf Arie Barg

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel
    Tel Hashomer, HaMerkaz, Israel

  • SL

    Sarina Levy-Mendelovich

    Pediatric hematologist in the National hemophilia and thrombosis center, Israel
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel
    Kiryat ono, HaMerkaz, Israel

  • Omri Cohen

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel.
    Tel Hashomer, HaMerkaz, Israel

  • LW

    Liat Waldman

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel
    Tel Hashomer, HaMerkaz, Israel

  • SL

    Shadan Lalezari

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel
    Tel Hashomer, HaMerkaz, Israel

    • Presenting Author(s)

  • Orly Efros, MD, MHA

    Physician-Researcher
    National Hemophilia Center and Thrombosis & Hemostasis Institute, Sheba Medical Center, Ramat Gan 52621, Israel, HaMerkaz, Israel

Background: Treatment with low-dose aspirin (LDA) and low-molecular heparin has significantly improved pregnancy conditions for patients with antiphospholipid syndrome (APS). However, in about 20% of these cases, standard treatments do not prevent obstetric complications. Treatment with hydroxychloroquine (HCQ) was shown to reduce disease flares and improve pregnancy outcomes. The effectiveness of HCQ for APS during pregnancy is still not well-established.

Aims: This meta-analysis aimed to evaluate the impact of HCQ on live birth and obstetric complication rates in pregnant women diagnosed with APS.

Methods: We performed a systematic search in PubMed and EMBASE databases in August 2023. The search strategy was carried out by using keywords and MeSH terms. We included original, peer reviewed studies that reported HCQ efficacy and safety in APS patients. Pooled proportions and odds ratios (ORs) along with their respective 95% confidence intervals (CIs) were computed.

Results: Eight observational studies met our inclusion criteria with a total of 1560 patients. Live birth occurred in 88.7% (95% CI, 85.5-91.3; 409/461 patients; seven studies) in the HCQ group, and in 67.4% (95% CI, 62.0-72.4; 207/307 patients; seven studies) in the non HCQ treated group. In the group treated with HCQ, obstetric complications were observed in 22.6% of the cases (95% CI, 17.8%-28.3; 55/243 patients; four studies) and in 58.1% (95% CI, 51.4-64.5; 126/217 patients; four studies) of the cases in the group not treated with HCQ. Treatment with HCQ was associated with higher rates of live-births (OR 2.22; 95% CI, 1.07-4.61) and lower obstetric complications (OR 0.19; 95% CI, 0.19-0.40) compared with no HCQ treatment. HCQ treatment during pregnancy was well tolerated with few reports of cutaneous reactions.

Conclusion(s): Our findings suggest that HCQ may offer potential benefits to APS patients during pregnancy by increasing live birth rates and improving obstetric morbidity with favourable safety profile.