Hydroxychloroquine use is associated with lower odds of persistently positive antiphospholipid antibodies and/or lupus anticoagulant in systemic lupus erythematosus.
Hydroxychloroquine use is associated with lower odds of persistently positive antiphospholipid antibodies and/or lupus anticoagulant in systemic lupus erythematosus.
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DOI：
10.3899/jrheum.120157
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发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Putterman C
中科院分区：
文献类型：
--
作者：
Broder A;Putterman C
抗磷脂抗体（aPL）在抗磷脂综合征（aPL）的发病机制中起着积极的作用。aPL的一级预防可能旨在降低现有的升高的aPL Ab水平，或者首先防止高aPL滴度和/或狼疮抗凝剂（LAC）的发展。在实验室研究中，羟基氯喹（HCQ）已被证明可以降低aPL滴度，并在回顾性研究中降低系统性红斑狼疮（SLE）患者的血栓形成风险。我们调查了SLE患者使用HCQ与持续aPL抗体和/或LAC之间的关系。我们确定了所有来自城市三级医疗中心的21岁以上SLE患者，他们至少两次测量了aPL、Abs和LAC，间隔至少12周。我们将持续LAC+和/或至少一个aPL Ab≥40单位（IgA， IgG或IgM）的存在定义为主要结局变量。在纳入研究的90例患者中，17例（19%）具有持续性LAC+和/或至少一种aPL Ab≥40单位。使用HCQ与持续LAC+和/或aPL抗体≥40 U的几率显著降低相关，or为0.21 (95% CI 0.05, 0.79) p=0.02，经年龄、种族和性别调整。这是第一个表明使用HCQ与LAC和/或aPL抗体持续阳性几率较低相关的研究。该研究的数据为未来前瞻性研究的设计提供了基础，研究HCQ在aPL一级和二级预防中的作用。
Antiphospholipid antibodies (aPL Abs) play an active role in the pathogenesis of the antiphospholipid syndrome (APLS). Primary prevention in APLS may be aimed at decreasing existing elevated aPL Ab levels, or preventing high aPL titers and/or lupus anticoagulant (LAC) from developing in the first place. Hydroxychloroquine (HCQ) has been shown to decrease aPL titers in laboratory studies, and to decrease thrombosis risk in systemic lupus erythematosus (SLE) patients in retrospective studies. We investigated an association between HCQ use and persistent aPL Abs and/or LAC in SLE. We identified all patients over 21 years old with SLE, from an urban tertiary care center, who had aPL Abs and LAC measured on at least 2 occasions, at least 12 weeks apart. We defined the presence of persistent LAC+ and/or at least one aPL Ab ≥ 40 units (IgA, IgG or IgM) as the main outcome variable. Among 90 patients included in the study, 17 (19%) had persistent LAC+ and/or at least one aPL Ab ≥ 40 units. HCQ use was associated with significantly lower odds of having persistent LAC+ and/or aPL Abs ≥ 40 U, OR 0.21 (95% CI 0.05, 0.79) p=0.02, adjusted for age, ethnicity, and gender. This is the first study to show that HCQ use is associated with lower odds of having persistently positive LAC and/or aPL Abs. Data from this study provides a basis for the design of future prospective studies investigating the role of HCQ in primary and secondary prevention of APLS.
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影响因子：
27.4
作者：
Erkan, D;Derksen, WJM;Lockshin, MD
通讯作者：
Lockshin, MD
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20.3
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