Would Hydroxychloroquine Be A New Promising Drug in Managing Antiphospholipid Syndrome?
Journal Title: Drug Designing & Intellectual Properties International Journal - Year 2018, Vol 2, Issue 4
Abstract
Once Antiphospholipid syndrome (APS) is diagnosed, risk profile of the patient will impact its management whether there was a previous thrombotic event or not, association with other autoimmune disorders, presence of other obstetrical complications as well as being currently pregnant. The current recommended regimen for preventing obstetrical complications. The current recommended regimen for preventing obstetrical complications includes low molecular weight Heparin and low dose aspirin. This regimen decreases the risk of miscarriage by only 54%. Here, we will review the studies that evaluated adding Hydroxychloroquine (HCQ) to the treatment of APS and how effective it would be. Antiphospholipid syndrome is an autoimmune disorder defined by the presence of either vascular thrombosis or characteristic obstetrical morbidities along with positive laboratory tests of circulating antibodies. Women with APS would present with pregnancy morbidities including three recurrent miscarriages before 10th week or unexplained stillbirth [1]. Once diagnosis is confirmed, management of APS is warranted to prevent obstetrical morbidities and risk of thrombosis which would reach 25% during pregnancy and the postpartum period. Long term follow- up revealed that 50% of women with APS but without thrombotic events would develop vascular thrombosis during 3-10 years and 10% would develop systematic lupus erythematosus (SLE) [2]. Different guidelines recommend prophylactic heparin during pregnancy and the postpartum period to prevent risk of thrombosis and increase the rate of live births [1, 3]. In a Cochrane review of randomized trials, combination of low dose aspirin and heparin decreases the risk of miscarriage by 54% [4]. Without any pharmacologic treatment, the live birth rate would reach only 10% in women suffering from APS with recurrent miscarriage [5]. Looking for other medications that would decrease risk of thrombosis, Hydroxychloroquine (HCQ) was historically evaluated to play this role. HCQ is an anti-malarial medication which is used to treat autoimmune rheumatic conditions gaining benefit from its ability to boost immune system against self-antigens [6]. In 1970s, placebo controlled randomized trials examined HCQ as a promising agent to prevent postoperative venous thrombosis in fields of general and orthopedic surgeries, but it failed [7,8]. Later, in a nested case control study of SLE patients with thrombosis matched with SLE controls without thrombosis, HCQ was associated with 68% decrease in risk of thrombosis.
Authors and Affiliations
Amani Mohsen, Rabih Chahine
Keywords
Related Articles
- EP ID EP588782
- DOI 10.32474/DDIPIJ.2018.02.000141
- Views 154
- Downloads 0
Semiconductor Quantum Dots as In-VivoImaging Agent
Inability to early diagnosis is a major concern for the treatment of fatal disease like cancer. Early diagnosis and treatment enhances the scope of disease curability. The accurate identification, real-time monitoring...
Phytochemical Analysis and Antioxidant Property of Selected Medicinal Plants Native to Cambodia
Cambodian medicinal plants have been used to treat different diseases such as cardiovascular diseases, inflammation, cancers, diabetes and AIDS. This study aimed at conducting the Phytochemical analysis and in vitro anti...
Would Hydroxychloroquine Be A New Promising Drug in Managing Antiphospholipid Syndrome?
Once Antiphospholipid syndrome (APS) is diagnosed, risk profile of the patient will impact its management whether there was a previous thrombotic event or not, association with other autoimmune disorders, presence of oth...
Current Challenges and Obstacles to Drug Development for Chagas Disease
Chagas disease is a protozoan infection which was first identified more than one hundred years ago. But even now, drugs to treat the latent and chronic phases of the disease are not available. The success of a drug desig...
FTIR Analysis & Dielectric Constant for Some Iron Bismuth Borate Glasses
Borate glasses contain transition metal ions are of high importance in science and technology, as solid electrolytes and electric sensors [1]. Oxide glasses, especially bismuth borate glasses, are considered as stable ac...