Pregnancy and Antiphospholipid Syndrome

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Rheumatology

Background:

• Antiphospholipid syndrome (APS) is linked to pregnancy complications like stillbirth and preeclampsia.
• Current treatments (aspirin and heparin) improve outcomes but fail in 20-30% of APS pregnancies.
• Recurrent pregnancy loss is a common obstetric complication in women with antiphospholipid antibodies (aPL).

Purpose of the Study:

• To evaluate the efficacy of hydroxychloroquine (HCQ) in preventing pregnancy complications in women with aPL.
• To provide scientific evidence on the use of HCQ in pregnant women diagnosed with APS.
• To explore alternative treatments for obstetric APS to improve fetal and maternal outcomes.

Main Methods:

• A randomized controlled multicenter trial (HYPATIA) comparing hydroxychloroquine (HCQ) versus placebo.
• Inclusion of pregnant women with antiphospholipid antibodies (aPL).
• Assessment of pregnancy outcomes in both treatment and placebo groups.

Main Results:

• Retrospective studies suggest hydroxychloroquine (HCQ) may prevent pregnancy complications in women with aPL.
• The HYPATIA trial will provide data on HCQ's effectiveness in obstetric APS.
• Further results are pending from the ongoing randomized controlled trial.

Conclusions:

• Improved treatments are needed for the 20-30% of APS pregnancies that do not respond to current therapies.
• Hydroxychloroquine (HCQ) shows potential as an adjunctive therapy for obstetric APS.
• The HYPATIA trial is crucial for establishing evidence-based guidelines for HCQ use in APS pregnancies.