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Hydroxychloroquine for the prevention of fetal growth restriction and prematurity in lupus pregnancy: A systematic review and meta-analysis - 15/11/18

Doi : 10.1016/j.jbspin.2018.03.006 
Vivien Guillotin a, 1, Alice Bouhet b, 1, Thomas Barnetche b, Christophe Richez b, Marie-Elise Truchetet b, Julien Seneschal c, Pierre Duffau d, 2, Estibaliz Lazaro e, 2,

Fédération Hospitalo-Universitaire Acronim

a Division of Internal Medicine, Bordeaux University Hospital, 33000 Bordeaux, France 
b Division of Rheumatology, Bordeaux University Hospital, 33000 Bordeaux, France 
c Division of Dermatology, Bordeaux University Hospital, 33000 Bordeaux, France 
d Division of Internal Medicine and Clinical Immunology, Saint-André Hospital, 33000 Bordeaux, France 
e Division of Internal Medicine and Infectious Diseases, Haut-Lévêque Hospital, 33604 Pessac, France 

Corresponding author at: Internal Medicine, Haut-Lévêque Hospital, Avenue Magellan, 33604 Pessac, France.Internal Medicine, Haut-Lévêque HospitalAvenue MagellanPessac33604France

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Highlights

Antiphospholipid syndrome, disease activity, tobacco consumption and socio-economic status strongly impact fetal outcomes during SLE pregnancy.
HCQ may reduce IUGR and preterm delivery in SLE pregnancy.
The efficacy of HCQ in the prevention of prematurity as well as IUGR during SLE pregnancies is not confirmed in this meta-analysis.
Our results should be interpreted with caution because of the heterogeneity of the studies and should not discourage the use of HCQ in this context.

El texto completo de este artículo está disponible en PDF.

Abstract

Objectives

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that primarily affects women of childbearing age. While the impact of hydroxychloroquine (HCQ) on SLE activity and neonatal lupus occurrence has been evaluated in several studies, its role on prematurity and intrauterine growth restriction (IUGR) remains uncertain. The aim of this study was to assess the impact of HCQ exposure on prematurity and IUGR during pregnancy in women with SLE.

Methods

We conducted a systematic review and a meta-analysis comparing prematurity and IUGR in SLE pregnancies exposed or not exposed to HCQ. The odds ratio of IUGR and prematurity were calculated and compared between pregnancies in each group according HCQ treatment.

Results

Six studies were included (3 descriptive cohort studies and 3 case series) totalling 870 pregnancies. Of the SLE pregnancies, 308 were exposed to HCQ and were compared to 562 not exposed to HCQ. There was no statistical difference for prematurity or IUGR between groups.

Conclusion

This meta-analysis failed to prove the efficacy of HCQ in the prevention of prematurity as well as IUGR during SLE pregnancies. Due to the heterogeneity of the studies, these results should be interpreted cautiously.

El texto completo de este artículo está disponible en PDF.

Keywords : Systemic lupus erythematosus, Hydroxychloroquine, Preterm birth, Intrauterine growth restriction, Meta-analysis, Systematic review


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© 2018  Société française de rhumatologie. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 85 - N° 6

P. 663-668 - décembre 2018 Regresar al número
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