Vivien Guillotin1, Alice Bouhet2, Thomas Barnetche2, Christophe Richez2, Marie-Elise Truchetet2, Julien Seneschal3, Pierre Duffau4, Estibaliz Lazaro5. 1. Division of Internal Medicine, Bordeaux University Hospital, 33000 Bordeaux, France. 2. Division of Rheumatology, Bordeaux University Hospital, 33000 Bordeaux, France. 3. Division of Dermatology, Bordeaux University Hospital, 33000 Bordeaux, France. 4. Division of Internal Medicine and Clinical Immunology, Saint-André Hospital, 33000 Bordeaux, France. 5. Division of Internal Medicine and Infectious Diseases, Haut-Lévêque Hospital, 33604 Pessac, France. Electronic address: estibaliz.lazaro@chu-bordeaux.fr.
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.
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.
Authors: Megan E B Clowse; Amanda M Eudy; Stephen Balevic; Gillian Sanders-Schmidler; Andrzej Kosinski; Rebecca Fischer-Betz; Dafna D Gladman; Yair Molad; Cecilia Nalli; Abir Mokbel; Angela Tincani; Murray Urowitz; Caroline Bay; Megan van Noord; Michelle Petri Journal: Lupus Sci Med Date: 2022-03