Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Review of the literature.
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.
Costedoat-Chalumeau
Nathalie
N
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
Amoura
Zahir
Z
Huong
Du Le Thi
DL
Lechat
Philippe
P
Piette
Jean-Charles
JC
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
D018501:Antirheumatic Agents; D006886:Hydroxychloroquine