RT Journal Article
SR Electronic
T1 Effect of hydroxychloroquine on pregnancy outcome in patients with SLE: a systematic review and meta-analysis
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP e001239
DO 10.1136/lupus-2024-001239
VO 11
IS 2
A1 Zhu, Qingmiao
A1 Wang, Jiayu
A1 Sun, Qice
A1 Xie, Zhijun
A1 Li, Rongqun
A1 Yang, Zi
A1 Song, Ziyu
A1 Yang, Kepeng
A1 Zhao, Ting
YR 2024
UL http://lupus.bmj.com/content/11/2/e001239.abstract
AB Objective Hydroxychloroquine (HCQ) is an antimalarial drug employed in the treatment of systemic lupus erythematosus (SLE). Prior studies reported inconsistent results regarding the association between HCQ use during pregnancy and adverse pregnancy outcomes. This study aimed to evaluate the impact of HCQ on pregnancy-related outcomes in women with SLE.Methods We conducted a systematic search for studies associating pregnancy outcomes with HCQ use in PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang database and VIP from inception to 22 September 2022. Random or fixed effect models were used to estimate the pooled effect based on I2 measurement of heterogeneity.Results Twenty-one studies were included, encompassing 929 and 1031 patients in HCQ and non-HCQ groups, respectively. We found that HCQ use was significantly associated with reduced risks of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores (second trimester: mean difference (MD) −1.80, 95% CI −2.46 to –1.13; third trimester: MD −2.30, 95% CI −3.31 to –1.29), flare (OR 0.57, 95% CI 0.33 to 0.97), preterm birth (OR 0.57, 95% CI 0.46 to 0.72), intrauterine growth retardation (IUGR) (OR 0.48, 95% CI 0.31 to 0.72), gestational hypertension (OR 0.19, 95% CI 0.08 to 0.42), pre-eclampsia (OR 0.46, 95% CI 0.29 to 0.72). In contrast, a positive correlation was observed between full-term birth and HCQ use (OR 2.01, 95% CI 1.52 to 2.65). However, the result for disease flare exhibited high heterogeneity (p=0.01, I2=59%). In addition, publication bias was detected in the meta-analysis of full-term birth using the Egger’s test.Conclusions This meta-analysis offers a comprehensive assessment of the relationship between disease activity, pregnancy-related outcomes and HCQ use, providing supportive evidence for the therapeutic effectiveness of HCQ in pregnant women with SLE.PROSPERO registration number CRD42022374468.All data relevant to the study are included in the article or uploaded as supplementary information.