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Open Access 23-09-2023 | Antiphospholipid Syndrome | Review

The effects of hydroxychloroquine and its promising use in refractory obstetric antiphospholipid syndrome

Authors: Juan J. Fierro, Manuela Velásquez-Berrío, Alexandra Ospina, Svenja Henning, Karina de Leeuw, Ángela P. Cadavid J

Published in: Rheumatology International | Issue 2/2024

Abstract

Hydroxychloroquine (HCQ) is obtained by hydroxylation of chloroquine (CQ) and the first indication was malaria. Nowadays, HCQ is commonly used in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) with favorable results. Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis and/or pregnancy morbidity and persistent positivity of antiphospholipid antibodies. Around 20–30% of pregnant women with APS develop adverse pregnancy outcomes despite conventional treatment with aspirin and heparin, called refractory obstetric APS. Interestingly, HCQ has shown positive effects on top of the standard of care in some refractory obstetric APS patients. HCQ mechanisms of action in APS comprise its ability to bind sialic acid present in cell membranes, its capacity to block the binding of antiphospholipid antibodies to the cell and the induced increase of pH in extracellular and intracellular compartments. However, the precise mechanisms of HCQ in the specific situation of refractory APS still need to be fully clarified. Therefore, this review summarizes the known modulating effects of HCQ and CQ, their side effects and use in APS and different pathologies to understand the benefit effects and the mechanism of action of HCQ in refractory obstetric APS.

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Title: The effects of hydroxychloroquine and its promising use in refractory obstetric antiphospholipid syndrome
Authors: Juan J. Fierro
Manuela Velásquez-Berrío
Alexandra Ospina
Svenja Henning
Karina de Leeuw
Ángela P. Cadavid J
Publication date: 23-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Antiphospholipid Syndrome
Antiphospholipid Syndrome
Hydroxychloroquine
Chloroquin
Chloroquin
Systemic Lupus Erythematosus
Rheumatoid Arthritis
Published in: Rheumatology International / Issue 2/2024
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-023-05457-5

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