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Maternal Use of Hydroxychloroquine Is Associated With a Reduced Risk of Recurrent Anti-SSA/Ro-Antibody- Associated Cardiac Manifestations of Neonatal Lupus

Circulation (New York, N.Y.), 2012-07, Vol.126 (1), p.76-82 [Tạp chí có phản biện]

2015 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.111.089268 ;PMID: 22626746 ;CODEN: CIRCAZ

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Maternal Use of Hydroxychloroquine Is Associated With a Reduced Risk of Recurrent Anti-SSA/Ro-Antibody- Associated Cardiac Manifestations of Neonatal Lupus
Tác giả: IZMIRLY, Peter M ; COSTEDOAT-CHALUMEAU, Nathalie ; PISONI, Cecilia N ; KHAMASHTA, Munther A ; KIM, Mimi Y ; SAXENA, Amit ; FRIEDMAN, Deborah ; LLANOS, Carolina ; PIETTE, Jean-Charles ; BUYON, Jill P
Chủ đề: Adult ; Antibodies, Antinuclear - blood ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cohort Studies ; Coronary heart disease ; Databases, Factual ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; France - epidemiology ; Heart ; Humans ; Hydroxychloroquine - therapeutic use ; Lupus Erythematosus, Systemic - blood ; Lupus Erythematosus, Systemic - congenital ; Lupus Erythematosus, Systemic - epidemiology ; Lupus Erythematosus, Systemic - prevention & control ; Male ; Medical sciences ; Pregnancy ; Pregnancy Complications, Cardiovascular - blood ; Pregnancy Complications, Cardiovascular - epidemiology ; Pregnancy Complications, Cardiovascular - prevention & control ; Risk Factors ; Secondary Prevention ; United Kingdom - epidemiology ; United States - epidemiology
Là 1 phần của: Circulation (New York, N.Y.), 2012-07, Vol.126 (1), p.76-82
Mô tả: A recent case-control study suggested a benefit of hydroxychloroquine (HCQ) in lowering the risk of cardiac manifestations of neonatal lupus (cardiac-NL) in pregnancies of anti-SSA/Ro-positive patients with systemic lupus erythematosus. A historical cohort assembled from 3 international databases was used to evaluate whether HCQ reduces the nearly 10-fold increase in risk of recurrence of cardiac-NL independently of maternal health status. Two hundred fifty-seven pregnancies of anti-SSA/Ro-positive mothers (40 exposed and 217 unexposed to HCQ) subsequent to the birth of a child with cardiac-NL were identified from 3 databases (United States, England, and France). Exposure was defined as the sustained use of HCQ throughout pregnancy with initiation before 10 weeks of gestation. The recurrence rate of cardiac-NL in fetuses exposed to HCQ was 7.5% (3 of 40) compared with 21.2% (46 of 217) in the unexposed group (P=0.050). Although there were no deaths in the exposed group, the overall case fatality rate of the cardiac-NL fetuses in the unexposed group was 21.7%. In a multivariable analysis that adjusted for database source, maternal race/ethnicity, and anti-SSB/La status, HCQ use remained significantly associated with a decreased risk of cardiac-NL (odds ratio, 0.23; 95% confidence interval, 0.06-0.92; P=0.037). Similar results were obtained with propensity score analysis, an alternative approach to adjust for possible confounding by indication. Aggregate data from a multinational effort show that in mothers at high risk of having a child with cardiac-NL, the use of HCQ may protect against recurrence of disease in a subsequent pregnancy.
Nơi xuất bản: Hagerstown, MD: Lippincott Williams & Wilkins
Ngôn ngữ: English
Số nhận dạng: ISSN: 0009-7322
EISSN: 1524-4539
DOI: 10.1161/CIRCULATIONAHA.111.089268
PMID: 22626746
CODEN: CIRCAZ
Nguồn: GFMER Free Medical Journals
MEDLINE

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Maternal Use of Hydroxychloroquine Is Associated With a Reduced Risk of Recurrent Anti-SSA/Ro-Antibody- Associated Cardiac Manifestations of Neonatal Lupus

2015 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;DOI: 10.1161/CIRCULATIONAHA.111.089268 ;PMID: 22626746 ;CODEN: CIRCAZ

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