Maternal Use of Hydroxychloroquine Is Associated With a Reduced Risk of Recurrent Anti-SSA/Ro-Antibody-Associated Cardiac Manifestations of Neonatal Lupus

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dc.contributor.authorIzmirly, Peter M.
dc.contributor.authorCostedoat Chalumeau, Nathalie
dc.contributor.authorPisoni, Cecilia N.
dc.contributor.authorKhamashta, Munther A.
dc.contributor.authorKim, Mimi Y.
dc.contributor.authorSaxena, Amit
dc.contributor.authorFriedman, Deborah
dc.contributor.authorLlanos, Carolina
dc.contributor.authorPiette, Jean Charles
dc.contributor.authorBuyon, Jill P.
dc.date.accessioned2024-01-10T12:06:31Z
dc.date.available2024-01-10T12:06:31Z
dc.date.issued2012
dc.description.abstractBackground-A recent case-control study suggested a benefit of hydroxychloroquine (HCQ) in lowering the risk of cardiac manifestations of neonatal lupus (cardiac-NL) in pregnancies of anti-SSA/Ro-positive patients with systemic lupus erythematosus. A historical cohort assembled from 3 international databases was used to evaluate whether HCQ reduces the nearly 10-fold increase in risk of recurrence of cardiac-NL independently of maternal health status.
dc.description.abstractMethods and Results-Two hundred fifty-seven pregnancies of anti-SSA/Ro-positive mothers (40 exposed and 217 unexposed to HCQ) subsequent to the birth of a child with cardiac-NL were identified from 3 databases (United States, England, and France). Exposure was defined as the sustained use of HCQ throughout pregnancy with initiation before 10 weeks of gestation. The recurrence rate of cardiac-NL in fetuses exposed to HCQ was 7.5% (3 of 40) compared with 21.2% (46 of 217) in the unexposed group (P = 0.050). Although there were no deaths in the exposed group, the overall case fatality rate of the cardiac-NL fetuses in the unexposed group was 21.7%. In a multivariable analysis that adjusted for database source, maternal race/ethnicity, and anti-SSB/La status, HCQ use remained significantly associated with a decreased risk of cardiac-NL (odds ratio, 0.23; 95% confidence interval, 0.06-0.92; P = 0.037). Similar results were obtained with propensity score analysis, an alternative approach to adjust for possible confounding by indication.
dc.description.abstractConclusion-Aggregate data from a multinational effort show that in mothers at high risk of having a child with cardiac-NL, the use of HCQ may protect against recurrence of disease in a subsequent pregnancy. (Circulation. 2012; 126:76-82.)
dc.description.funderNational Institute of Arthritis and Musculoskeletal and Skin Disease
dc.description.funderKirkland Scholars Grant
dc.description.funderLupus Foundation of Minnesota
dc.description.funderAmerican Heart Association
dc.description.funderPfizer
dc.description.funderNATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
dc.fechaingreso.objetodigital2024-05-20
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1161/CIRCULATIONAHA.111.089268
dc.identifier.eissn1524-4539
dc.identifier.issn0009-7322
dc.identifier.pubmedidMEDLINE:22626746
dc.identifier.urihttps://doi.org/10.1161/CIRCULATIONAHA.111.089268
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/76172
dc.identifier.wosidWOS:000306977100026
dc.information.autorucMedicina;Llanos C ;S/I;1007976
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final82
dc.pagina.inicio76
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaCIRCULATION
dc.rightsacceso restringido
dc.subjectanti-SSA/Ro antibody
dc.subjectcardiomyopathies
dc.subjectcongenital heart block
dc.subjecthydroxychloroquine
dc.subjectneonatal lupus
dc.subjectprevention and control
dc.subjectCONGENITAL HEART-BLOCK
dc.subjectINTRAVENOUS IMMUNOGLOBULIN
dc.subjectERYTHEMATOSUS
dc.subjectFETAL
dc.subjectMOTHERS
dc.subjectFETUSES
dc.subjectMULTICENTER
dc.subjectPREGNANCIES
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleMaternal Use of Hydroxychloroquine Is Associated With a Reduced Risk of Recurrent Anti-SSA/Ro-Antibody-Associated Cardiac Manifestations of Neonatal Lupus
dc.typeartículo
dc.volumen126
sipa.codpersvinculados1007976
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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