RT Journal Article SR Electronic T1 CS-03 Hydroxychloroquine in lupus pregnancy: a meta-analysis of individual participant data JF Lupus Science & Medicine JO Lupus Sci & Med FD Lupus Foundation of America SP A21 OP A21 DO 10.1136/lupus-2018-lsm.38 VO 5 IS Suppl 2 A1 Eudy, Amanda M A1 Petri, Michelle A1 Fischer-Betz, Rebecca A1 Mokbel, Abeer A1 Nalli, Cecilia A1 Andreoli, Laura A1 Tincani, Angela A1 Molad, Yair A1 Gladman, Dafna A1 Urowitz, Murray A1 Balevic, Stephen A1 Clowse, Megan EB YR 2018 UL http://lupus.bmj.com/content/5/Suppl_2/A21.1.abstract AB Background Our current knowledge about how to treat lupus in pregnancy derives from small prospective or retrospective cohorts. The goal of this individual participant meta-analysis was to pool data from multiple prospective cohorts to answer the clinical question of whether hydroxychloroquine (HCQ) treatment affects pregnancy outcomes.Methods The literature was searched for prospective cohorts of pregnancies among women with lupus. HCQ use was defined as use any time during pregnancy. Outcomes of interest included fetal loss, preterm birth, high disease, and preeclampsia. Data from each cohort were collected and analyzed individually. Pooled ORs were calculated by random-effect models in Review Manager. Due to multiple pregnancies per patient, one pregnancy was randomly selected per patient. Primary analysis included only women with first trimester visits (6 cohorts). Subgroup analyses were stratified by a history of nephritis, APS, and disease activity at first clinic visit.Results The literature was searched for prospective cohorts of pregnancies among women with lupus. HCQ use was defined as use any time during pregnancy. Outcomes of interest included fetal loss, preterm birth, high disease, and preeclampsia. Data from each cohort were collected and analyzed individually. Pooled ORs were calculated by random-effect models in Review Manager. Due to multiple pregnancies per patient, one pregnancy was randomly selected per patient. Primary analysis included only women with first trimester visits (6 cohorts). Subgroup analyses were stratified by a history of nephritis, APS, and disease activity at first clinic visit.View this table:Abstract CS-03 Table 1 Pooled odds ratios for the association of hydroxychloroquine use and pregnancy outcomesConclusions Our results suggest that among patients with lupus nephritis, HCQ use may decrease the risk of fetal loss. The heterogeneity of data collection suggests the need for a unified approach to identify larger cohorts of lupus pregnancies.