ABSTRACT
PURPOSE: To evaluate the efficacy of additional treatment with hydroxychloroquine (HCQ) for pregnant women with persistent positive antiphospholipid antibodies or antiphospholipid antibody syndrome (APS). METHOD: We conducted a systematic search of the PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases from inception to 31th December 2019. Two authors performed study selection, data collection, and data analysis independently. RESULT: Five retrospective studies involving 477 pregnancies were selected. The live birth rate was significantly improved in the experimental group (OR, 3.29; 95 % CI, 1.45-7.49; P = 0.004). Additionally, pregnancy loss was associated with the additional use of HCQ (OR, 0.30;95 % CI, 0.13-0.69; P = 0.004). However, HCQ had no significant association with preterm delivery (OR, 0.43; 95 % CI, 0.13-1.37; P = 0.16) and fetal growth restriction showed an OR of 0.22 (95 % CI, 0.13-1.88; P = 0.55). CONCLUSION: These data suggest that receiving HCQ as an additional treatment can improve the live birth rate in pregnant women with persistent antiphospholipid antibodies.
Subject(s)
Antiphospholipid Syndrome/drug therapy , Hydroxychloroquine/pharmacology , Pregnancy Rate/trends , Adult , Female , Humans , Hydroxychloroquine/immunology , Hydroxychloroquine/therapeutic use , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications/prevention & controlABSTRACT
O Ministério da Saúde divulgou novas orientações para uso de medicamentos, mantendo o uso da cloroquina ou da hidroxicloroquina, no tratamento precoce de pacientes com Covid-19, no Sistema Único de Saúde (SUS)
Subject(s)
Coronavirus Infections , Hydroxychloroquine/immunology , Drug PrescriptionsSubject(s)
Anti-Inflammatory Agents/adverse effects , Desensitization, Immunologic/methods , Drug Hypersensitivity/immunology , Hydroxychloroquine/adverse effects , Hydroxychloroquine/immunology , Anti-Inflammatory Agents/immunology , Female , Humans , Lupus Nephritis/drug therapy , Pruritus/chemically induced , Urticaria/chemically induced , Young AdultSubject(s)
Antiphospholipid Syndrome/drug therapy , Desensitization, Immunologic/methods , Drug Hypersensitivity/diagnosis , Drug-Related Side Effects and Adverse Reactions/diagnosis , Hydroxychloroquine/adverse effects , Lupus Erythematosus, Systemic/drug therapy , Skin/pathology , Aged, 80 and over , Clinical Protocols , Drug Hypersensitivity/etiology , Drug Hypersensitivity/therapy , Drug-Related Side Effects and Adverse Reactions/therapy , Humans , Hydroxychloroquine/immunology , Hydroxychloroquine/therapeutic use , Hypersensitivity, Delayed , Immune Tolerance , Male , Treatment OutcomeSubject(s)
Anaphylaxis/therapy , Desensitization, Immunologic , Drug Hypersensitivity/therapy , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/therapy , Adolescent , Allergens/immunology , Anaphylaxis/chemically induced , Anaphylaxis/immunology , Clinical Protocols , Drug Hypersensitivity/complications , Drug Hypersensitivity/immunology , Female , Humans , Hydroxychloroquine/immunology , Lupus Erythematosus, Systemic/complicationsSubject(s)
Anaphylaxis/immunology , Antirheumatic Agents/adverse effects , Antirheumatic Agents/immunology , Desensitization, Immunologic , Hydroxychloroquine/adverse effects , Hydroxychloroquine/immunology , Antirheumatic Agents/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Male , Middle Aged , Pericarditis/drug therapy , Pericarditis/etiology , Skin TestsSubject(s)
Antirheumatic Agents/immunology , Desensitization, Immunologic/methods , Drug Eruptions/therapy , Drug Hypersensitivity/therapy , Hydroxychloroquine/immunology , Antirheumatic Agents/adverse effects , Drug Eruptions/etiology , Drug Eruptions/pathology , Drug Hypersensitivity/etiology , Drug Hypersensitivity/pathology , Drug Tolerance/immunology , Humans , Hydroxychloroquine/adverse effects , Rheumatic Diseases/complications , Rheumatic Diseases/drug therapyABSTRACT
Hydroxychloroquine (HCQ) is an antimalarial agent with immunomodulatory effects. It is widely used in rheumatologic diseases, and has a very high efficacy/toxicity ratio. It is particularly important in the treatment of systemic lupus erythematosus (SLE) since it reduces new organ involvement and disease flares, and relieves skin and joint symptoms. Some patients develop hypersensitivity rash in response to HCQ. In such patients the drug is withdrawn and replaced by another medication. All the alternative medications for rheumatological patients are significantly more toxic than HCQ. We describe our initial experience of HCQ slow oral desensitization. All 4 patients who were recruited completed the procedure successfully without significant difficulty. Our results suggest that HCQ slow oral desensitization is safe, effective, and easy to perform.
Subject(s)
Antirheumatic Agents/immunology , Desensitization, Immunologic/methods , Drug Eruptions/therapy , Drug Hypersensitivity/therapy , Hydroxychloroquine/immunology , Adult , Antirheumatic Agents/adverse effects , Drug Eruptions/etiology , Drug Hypersensitivity/etiology , Drug Tolerance/immunology , Female , Humans , Hydroxychloroquine/adverse effects , Middle Aged , Rheumatic Diseases/complications , Rheumatic Diseases/drug therapyABSTRACT
O presente trabalho aborda o tratamento sintomático da reação leprótica pelo sulfato de Hidroxicloroquina. Especial atenção foi dedicada às normas que devem reger as pesquisas terapêuticas relacionadas com a reação leprótica. O autor considera que as seguintes normas devem ser respeitadas: 1- Deve sempre existir um grupo "controle", tratado com placebo indêntico à droga usada. 2- Todos os pacientes devem ser internados. 3- A experiência deve ser conduzida "às cegas", evitando assim a influência psicológica que o médico possa ter sobre o doente. Isto é alcançado quando o pesquisador descobre qual o grupo tratado e qual o grupo contrôle. 4- Nenhum medicamento deve ser usado, afim de não perturbar o rigorismo da pesquisa. Nem mesmo antérmicos ou analgésicos, vitaminas, soluções endovenosas, etc, devem ser usados. 5- Os doentes escolhidos devem apresentar um quadro tanto quanto poss¡vel uniforme. Excluam-se os casos leves, bem como os demasiadamente severos que comprometem o estado geral (estes por não poderem prescindir da medicação de "suspensão"). 6- Todos os casos devem ser lepromatosos, excluindo-se desde logo os lepromatoides reacionais. Foram estudados dois grupos com vinte doentes em cada um, um dos quais recebeu a substância ativa e o outro serviu de testemunho, recebendo placebo indêntico à droga usada. Após a comparação de resultados, verificou-se não ter havido diferença significante entre ambos os grupos.
