Summary of studies investigating HCQ use in patients with aPL, with and without SLE
| Author/year . | Study design . | N . | aPL measurements (positive rate) . | % of HCQ or use of antimalarials . | Intervention/ comparison . | Results (thrombosis rate) . | |
|---|---|---|---|---|---|---|---|
| SLE, primary prevention | |||||||
| Wallace et al 199316 | Retrospective cohort | 96 | NA (100% positive) | NA | HCQ ever use vs no use | 11% in HCQ users vs 20% in nonusers | |
| Ho et al 200512 | Prospective cohort | 442 | ≥1 (positivity rate NA) | NA | HCQ ever use vs no use | OR 0.54 (95% CI, 0.30-0.95) (univariate)* | |
| Mok CC et al 200513 | Prospective cohort | 625 | ≥1 (38.4% positive) | NA | HCQ ever use vs no use | OR 0.73 (95% CI, 0.38-1.40)*,† | |
| Mok MY et al 200517 | Retrospective cohort | 83 | ≥2, ≥6 weeks apart (100% positive) | 55.9% | HCQ ever use vs no use | HR 0.21 (95% CI, 0.06-0.81) | |
| Ruiz-Irastorza et al 200614 | Prospective cohort | 232 | ≥1 (45.6% positive) | 64% | Antimalarials‡ ever use vs no use | HR 0.28 (95% CI, 0.08-0.90)* | |
| Tektonidou et al 20096 | Retrospective case-control | 144 | ≥2, ≥12 weeks apart (100% positive) | 70% | HCQ ever use vs no use | HR per month of use: 0.99 (95% CI, 0.98-1.00) | |
| Kaiser et al 20097 | Retrospective cohort | 1930 | ≥1 (27% positive) | 80% | HCQ ever use vs no use | HR 0.67 (95% CI, 0.50-0.90)* | |
| Jung et al 201018 | Retrospective, nested case-control | 162 | ≥1 (27.4% positive) | 32.7% | Antimalarials‡ ever use vs no use‡ | OR 0.32 (95% CI, 0.14-0.74) (multivariate)* | |
| Arnaud et al 201520 | Patient level meta-analysis | 192 | NA (100% positive) | 43.8% | HCQ ever use vs no use | HR: 0.67 (95% CI, 0.34-1.32)§ | |
| aPL, positive primary prevention | |||||||
| Erkan et al 200219 | Retrospective, cross-sectional | 133 | ≥2, ≥6 weeks apart (100% positive) | Use of HCQ: 4/77 (5.2%) APS patients vs 21/56 (37.5%) asymptomatic aPL-positive patients (P < 0.001) | |||
| APS, secondary prevention | |||||||
| Schmidt-Tanguy et al 201315 | Prospective nonrandomized | 40 | ≥2, ≥12 weeks apart | 50% | HCQ plus OA vs OA only | 0% in HCQ users vs 30% in nonusers (P = .0086) | |
| Author/year . | Study design . | N . | aPL measurements (positive rate) . | % of HCQ or use of antimalarials . | Intervention/ comparison . | Results (thrombosis rate) . | |
|---|---|---|---|---|---|---|---|
| SLE, primary prevention | |||||||
| Wallace et al 199316 | Retrospective cohort | 96 | NA (100% positive) | NA | HCQ ever use vs no use | 11% in HCQ users vs 20% in nonusers | |
| Ho et al 200512 | Prospective cohort | 442 | ≥1 (positivity rate NA) | NA | HCQ ever use vs no use | OR 0.54 (95% CI, 0.30-0.95) (univariate)* | |
| Mok CC et al 200513 | Prospective cohort | 625 | ≥1 (38.4% positive) | NA | HCQ ever use vs no use | OR 0.73 (95% CI, 0.38-1.40)*,† | |
| Mok MY et al 200517 | Retrospective cohort | 83 | ≥2, ≥6 weeks apart (100% positive) | 55.9% | HCQ ever use vs no use | HR 0.21 (95% CI, 0.06-0.81) | |
| Ruiz-Irastorza et al 200614 | Prospective cohort | 232 | ≥1 (45.6% positive) | 64% | Antimalarials‡ ever use vs no use | HR 0.28 (95% CI, 0.08-0.90)* | |
| Tektonidou et al 20096 | Retrospective case-control | 144 | ≥2, ≥12 weeks apart (100% positive) | 70% | HCQ ever use vs no use | HR per month of use: 0.99 (95% CI, 0.98-1.00) | |
| Kaiser et al 20097 | Retrospective cohort | 1930 | ≥1 (27% positive) | 80% | HCQ ever use vs no use | HR 0.67 (95% CI, 0.50-0.90)* | |
| Jung et al 201018 | Retrospective, nested case-control | 162 | ≥1 (27.4% positive) | 32.7% | Antimalarials‡ ever use vs no use‡ | OR 0.32 (95% CI, 0.14-0.74) (multivariate)* | |
| Arnaud et al 201520 | Patient level meta-analysis | 192 | NA (100% positive) | 43.8% | HCQ ever use vs no use | HR: 0.67 (95% CI, 0.34-1.32)§ | |
| aPL, positive primary prevention | |||||||
| Erkan et al 200219 | Retrospective, cross-sectional | 133 | ≥2, ≥6 weeks apart (100% positive) | Use of HCQ: 4/77 (5.2%) APS patients vs 21/56 (37.5%) asymptomatic aPL-positive patients (P < 0.001) | |||
| APS, secondary prevention | |||||||
| Schmidt-Tanguy et al 201315 | Prospective nonrandomized | 40 | ≥2, ≥12 weeks apart | 50% | HCQ plus OA vs OA only | 0% in HCQ users vs 30% in nonusers (P = .0086) | |
NA, not available/unknown; OA, oral anticoagulation.
OR/HR was calculated by including all study patients, only some of whom were aPL positive. OR/HR not marked by an asterisk were based on only patients with positive aPL.
For venous thrombosis only. The arterial thrombosis rate was reported to be similar (data not shown).
Antimalarials include HCQ or chloroquine or both.
The study included a total of 497 patients, but the only available HR for HCQ use was calculated from the 192 patients with SLE.