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Effect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Study

2018Journal article Open access
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dc.contributor.authorRuffatti, A
dc.contributor.authorTonello, M
dc.contributor.authorHoxha, A
dc.contributor.authorSciascia, S
dc.contributor.authorCuadrado, MJ
dc.contributor.authorLatino, JO
dc.contributor.authorUdry, S
dc.contributor.authorReshetnyak, T
dc.contributor.authorCostedoat-Chalumeau, N
dc.contributor.authorMorel, N
dc.contributor.authorMarozio, L
dc.contributor.authorTincani, A
dc.contributor.authorAndreoli, L
dc.contributor.authorHaladyj, E
dc.contributor.authorMeroni, PL
dc.contributor.authorGerosa, M
dc.contributor.authorAlijotas-Reig, J
dc.contributor.authorTenti, S
dc.contributor.authorMayer-Pickel, K
dc.contributor.authorSimchen, MJ
dc.contributor.authorBertero, MT
dc.contributor.authorDe Carolis, S
dc.contributor.authorRamoni, V
dc.contributor.authorMekinian, A
dc.contributor.authorGrandone, E
dc.contributor.authorMaina, A
dc.contributor.authorSerrano, F
dc.contributor.authorPengo, V
dc.contributor.authorKhamashta, MA
dc.date.accessioned2019-10-11T10:12:57Z
dc.date.available2019-10-11T10:12:57Z
dc.date.issued2018
dc.description.abstractThe effect of additional treatments combined with conventional therapy on pregnancy outcomes was examined in high-risk primary antiphospholipid syndrome (PAPS) patients to identify the most effective treatment strategy. The study's inclusion criteria were (1) positivity to lupus anticoagulant alone or associated with anticardiolipin and/or anti-β2 glycoprotein I antibodies; (2) a history of severe maternal-foetal complications (Group I) or a history of one or more pregnancies refractory to conventional therapy leading to unexplained foetal deaths not associated with severe maternal-foetal complications (Group II). Two different additional treatments were considered: oral-low-dose steroids (10-20 mg prednisone daily) and/or 200 to 400 mg daily doses of hydroxychloroquine and parenteral-intravenous immunoglobulins at 2 g/kg per month and/or plasma exchange. The study's primary outcomes were live birth rates and pregnancy complications. A total of 194 pregnant PAPS patients attending 20 tertiary centres were retrospectively enrolled. Hydroxychloroquine was found to be linked to a significantly higher live birth rate with respect to the other oral treatments in the Group II patients. The high (400 mg) versus low (200 mg) doses of hydroxychloroquine (p = 0.036) and its administration before versus during pregnancy (p = 0.021) were associated with a significantly higher live birth rate. Hydroxychloroquine therapy appeared particularly efficacious in the PAPS patients without previous thrombosis. Parenteral treatments were associated with a significantly higher live birth rate with respect to the oral ones (p = 0.037), particularly in the Group I patients. In conclusion, some additional treatments were found to be safe and efficacious in high-risk PAPS pregnant women.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationThromb Haemost. 2018 Apr;118(4):639-646.pt_PT
dc.identifier.doi10.1055/s-0038-1632388pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3318
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherThieme Publishingpt_PT
dc.subjectAdministration, Oralpt_PT
dc.subjectAdultpt_PT
dc.subjectAntibodies, Anticardiolipinpt_PT
dc.subjectAntibodies, Antiphospholipidpt_PT
dc.subjectAntiphospholipid Syndromept_PT
dc.subjectBirth Ratept_PT
dc.subjectCombined Modality Therapypt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectHydroxychloroquinept_PT
dc.subjectImmunoglobulins, Intravenouspt_PT
dc.subjectLive Birthpt_PT
dc.subjectLupus Coagulation Inhibitorpt_PT
dc.subjectPlasma Exchangept_PT
dc.subjectPregnancypt_PT
dc.subjectPregnancy Complicationspt_PT
dc.subjectPregnancy Outcomept_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRiskpt_PT
dc.subjectSteroidspt_PT
dc.subjectThrombosispt_PT
dc.subjectMAC GINpt_PT
dc.titleEffect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage646pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage639pt_PT
oaire.citation.titleThrombosis and Haemostasispt_PT
oaire.citation.volume118pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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