title: Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Review of the literature.
abstract: Hydroxychloroquine (HCQ) is widely used in the treatment of systemic lupus erythematosus (SLE). Even if it is generally agreed that pregnancy per se increases disease activity in patients with SLE and that withdrawal of HCQ at the onset of pregnancy may result in exacerbation of SLE, use of HCQ during pregnancy has remained controversial for a long time. Parke was the first to propose continuation of HCQ throughout gestation. Currently, more than 250 pregnancies resulting in live births have been reported and no increase in the rate of birth defects have been demonstrated. When studied, no retinal toxicity and ototoxicity have been found. Data concerning lactation and HCQ treatment are rare. However, the amount of HCQ received by children through lactation seems very low. In conclusion, HCQ should probably be maintained throughout pregnancy in patients with SLE and it does not seem necessary to advise against breastfeeding.
authors.affiliation: Service de Médecine Interne, Centre Hospitalier Universitaire Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. nathalie.costedoat@psl.ap-hop-paris.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: Du Le Thi
authors.initials: DL
authors.lastname: Huong
authors.forename: Philippe
authors.initials: P
authors.lastname: Lechat
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001942:Breast Feeding; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D018501:Antirheumatic Agents; D006886:Hydroxychloroquine