Aim: Hydroxychloroquine (HCQ) could form an alternative treatment for thrombotic primary antiphospholipid syndrome (t-PAPS) if HCQ is proven to reduce the risk of thrombosis. We investigated whether HCQ affects immune response and lipid metabolism in t-PAPS.
Methods: HCQ at 400mg/day was given to anticoagulated t-PAPS patients for 6 months. After HCQ withdrawal and a wash-out period of 6 months, the same patients were followed for further 6 months. Blood samples taken at baseline and at the end of each 6-months follow-up period were analyzed employing flow cytometry and biochemical assays.
Result: Twenty-seven patients were included, mean age was 44 years, 78% were female, 44% had hypertension, 44% dyslipidemia, 7% diabetes, 77% had venous thrombosis, 30% arterial thrombosis and 33% recurrent thrombosis. Triple aPL positivity was detected in 37%. Lymphocyte counts decreased during HCQ use (mean change -318/mm3; 95%CI -438 to -198) and were not changed during non-HCQ use period. CD8+ and CD4+ cells decreased during HCQ treatment and remained unchanged during non-treatment period. In contrast, TREG (FoxP3+) cells increased during HCQ treatment (mean change 0.2U; 95%CI 0 to 0.4) and decreased in the period of non-HCQ treatment (mean change -0.6U; 95%CI -0.9 to -0.1). Serum glucose, total cholesterol and low density lipoprotein cholesterol decreased during HCQ use (7%, 9% and 12% respectively) and did not change substantially during non-HCQ period.
Conclusion: HCQ reduces cytotoxic T lymphocytes, increases regulatory T lymphocytes and decreases LDL cholesterol and serum glucose levels in t-PAPS. These HCQ may contribute to reduce the risk of thrombosis.
No relevant conflicts of interest to declare.
This feature is available to Subscribers Only
Sign In or Create an Account Close Modal