Long-term use of hydroxychloroquine reduces antiphospholipid antibodies levels in patients with primary antiphospholipid syndrome
Abstract
Hydroxychloroquine (HCQ) was suggested to play a role in lowering antiphospholipid antibody titers and preventing thrombotic recurrences in patients with systemic lupus erythematosus, but few data are available in patients with primary antiphospholipid syndrome (PAPS). In this retrospective, propensity score-matched cohort study, we evaluated the impact of HCQ on aPL titers and the incidence of thrombotic events in 57 exposed patients compared to 57 not exposed patients. These were matched for sex/type of disease onset/follow-up duration, age at the beginning of the follow-up ±10 years and initial date of the follow-up ±5 years. At baseline, no significant differences in demographical, clinical and serological features were observed between the two groups except for positive anti-extractable nuclear antigen antibodies (21 % in HCQ exposed vs 0 % in HCQ not exposed, P = 0.001). Both the levels of IgG anti-cardiolipin and IgG/IgM anti-β2-glycoprotein I (anti-β2GPI) were significantly reduced at end of follow-up compared to the baseline in HCQ-exposed patients, while there were no differences in the other group. Moreover, anti-β2GPI IgG titers were significantly decreased when the end of follow-up was compared between the two groups (P < 0.002). Among patients with a history of thrombosis, the annual incidence of recurrence was 1.16 % in HCQ exposed and 1.71 % in not exposed patients, with a significant reduction in the incidence of arterial events (0 vs 1.14 %). This study shows a strong reduction in aPL titers together with an apparent decrease in the incidence of arterial thrombosis recurrence in PAPS patients treated with HCQ.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Three clinical studies met inclusion criteria, comprising 164 adult patients with thrombotic primary antiphospholipid syndrome, of whom 82 received hydroxychloroquine and 82 received standard therapy alone.
“Three clinical studies met the inclusion criteria, comprising a total of 164 adult patients with thrombotic primary antiphospholipid syndrome (PAPS), of whom 82 received hydroxychloroquine (HCQ) in addition to standard antithrombotic therapy and 82 received standard therapy alone [8–10].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
In Nuri et al., 57 hydroxychloroquine-treated patients with primary antiphospholipid syndrome were matched to 57 controls without hydroxychloroquine exposure and followed longitudinally.
“In the multicenter retrospective propensity score-matched cohort by Nuri et al., 57 HCQ-treated patients with PAPS were matched to 57 controls without HCQ exposure and followed longitudinally [9].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
Across included studies, patients were predominantly female (approximately 70-80% when reported) and all had a documented history of objectively confirmed thrombosis fulfilling APS classification criteria.
“Across studies, patients were predominantly female (approximately 70–80% women, when reported), and all had a documented history of objectively confirmed thrombosis fulfilling APS classification criteria.”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
High-risk antiphospholipid antibody profiles (lupus anticoagulant positivity and/or double antiphospholipid antibody positivity) were frequent, although reporting of triple positivity was heterogeneous.
“High-risk antiphospholipid antibody profiles (lupus anticoagulant positivity and/or double aPL positivity) were frequent, although reporting of triple positivity was heterogeneous [8–10].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
The three included studies were a randomized prospective trial in Greece, a retrospective multicenter propensity score-matched cohort in Italy, and a prospective non-randomized controlled study in France.
“One study was a randomized prospective trial conducted in Greece [8], one a retrospective multicenter propensity score-matched cohort from Italy [9], and one a prospective non-randomized controlled study from France [10].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
In Nuri et al., arterial thrombotic recurrences occurred exclusively in the control group, whereas no arterial events were observed among hydroxychloroquine-treated patients during follow-up.
“Notably, arterial thrombotic recurrences occurred exclusively in the control group, whereas no arterial events were observed among HCQ-treated patients during follow-up.”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
In Nuri et al., among patients with prior thrombosis, the annual incidence of thrombotic recurrence was 1.16% in the hydroxychloroquine group versus 1.71% in the control group, corresponding to a relative risk reduction of approximately 32%.
“Among patients with prior thrombosis, the annual incidence of thrombotic recurrence was 1.16% in the HCQ group versus 1.71% in the control group, corresponding to a relative risk reduction of approximately 32%.”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
In Nuri et al., hydroxychloroquine exposure was associated with a statistically significant reduction in IgG anticardiolipin and anti-β2-glycoprotein I antibody titers, whereas antibody levels remained largely unchanged in controls.
“In parallel, HCQ exposure was associated with a statistically significant reduction in IgG anticardiolipin and anti-β2-glycoprotein I antibody titers, whereas antibody levels remained largely unchanged in controls [9].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
The majority of patients had experienced venous thromboembolism as the index event, while arterial thrombosis accounted for a smaller but clinically relevant proportion of cases.
“The majority of patients had experienced venous thromboembolism as the index event, while arterial thrombosis accounted for a smaller but clinically relevant proportion of cases.”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
The absence of a bleeding signal attributable to hydroxychloroquine in any of the included studies supports its favorable risk-benefit profile.
“The absence of a bleeding signal attributable to HCQ in any of the included studies further supports its favorable risk–benefit profile [8–10].”
From Hydroxychloroquine as an Adjunct Therapy for Secondary Thrombosis Prevention in Primary Antiphospholipid Syndrome: A Systematic Review and Meta-analysis (2026) · cites this paper as [9]
Cites
MIYAKIS, S., LOCKSHIN, M. D., ATSUMI, T., BRANCH, D. W., BREY, R. L., CERVERA, R., DERKSEN, R. H. W. M., DE GROOT, P. G., KOIKE, T., MERONI, P. L., et al. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2006.01753.x · Cited by 7,203 · see citing works
Self-citationUpdate of the guidelines for lupus anticoagulant detection
PENGO, V., TRIPODI, A., REBER, G., RAND, J. H., ORTEL, T. L., GALLI, M., & DE GROOT, P. G. (2009) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2009.03555.x · Cited by 1,197 · see citing works
Self-citationCervera, R., Serrano, R., Pons-Estel, G. J., Ceberio-Hualde, L., Shoenfeld, Y., de Ramón, E., Buonaiuto, V, Jacobsen, S., Zeher, M. M., Tarr, T., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2013-204838 · Cited by 974 · see citing works
Self-citationThe Canadian Hydroxychloroquine Study Group* (1991) · New England Journal of Medicine · doi:10.1056/nejm199101173240303 · Cited by 689 · see citing works
Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome
PENGO, V., RUFFATTI, A., LEGNANI, C., GRESELE, P., BARCELLONA, D., ERBA, N., TESTA, S., MARONGIU, F., BISON, E., DENAS, G., et al. (2010) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2009.03674.x · Cited by 633 · see citing works
Self-citationRuiz-Irastorza, G., Cuadrado, M., Ruiz-Arruza, I., Brey, R., Crowther, M., Derksen, R., Erkan, D., Krilis, S., Machin, S., Pengo, V, et al. (2011) · Lupus · doi:10.1177/0961203310395803 · Cited by 506 · see citing works
Self-citationEffect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus
Ruiz-Irastorza, G., Egurbide, M.-V., Pijoan, J.-I., Garmendia, M., Villar, I., Martinez-Berriotxoa, A., Erdozain, J.-G., & Aguirre, C. (2006) · Lupus · doi:10.1177/0961203306071872 · Cited by 411 · see citing works
Petri, M., Lakatta, C., Magder, L., & Goldman, D. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90151-1 · Cited by 323 · see citing works
Jung, H., Bobba, R., Su, J., Shariati‐Sarabi, Z., Gladman, D. D., Urowitz, M., Lou, W., & Fortin, P. R. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27289 · Cited by 291 · see citing works
Hydroxychloroquine use in the Baltimore Lupus Cohort: effects on lipids, glucose and thrombosis
Petri, M. (1996) · Lupus · doi:10.1177/0961203396005001051 · Cited by 259 · see citing works
Kaiser, R., Cleveland, C. M., & Criswell, L. A. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.093013 · Cited by 244 · see citing works
Wallace, D. J., METZGER, A. L., Stecher, V. J., Turnbull, B. A., & Kern, P. A. (1990) · The American Journal of Medicine · doi:10.1016/0002-9343(90)90345-e · Cited by 230 · see citing works
Rand, J. H., Wu, X.-X., Quinn, A. S., Chen, P. P., Hathcock, J. J., & Taatjes, D. J. (2008) · Blood · doi:10.1182/blood-2008-03-144204 · Cited by 215 · see citing works
Petri, M. (2011) · Current Rheumatology Reports · doi:10.1007/s11926-010-0141-y · Cited by 206 · see citing works
Dr., N. L. P., & Levine, C. C. (2004) · Springer eBooks · doi:10.1007/3-540-29668-9_242 · Cited by 181 · see citing works
Goldman, F. D., Gilman, A. L., Hollenback, C., Kato, R. M., Premack, B. A., & Rawlings, D. J. (2000) · Blood · doi:10.1182/blood.v95.11.3460 · Cited by 178 · see citing works
Biochemical characterization of ADP-ribose polymer metabolism in SLE
Chen, H.-Y., Pertusi, R. M., Kirkland, J., Rubin, B. R., & Jacobson, E. L. (1996) · Lupus · doi:10.1177/096120339600500105 · Cited by 162 · see citing works
Anti-beta 2-glycoprotein I antibodies: a marker of antiphospholipid syndrome?
Balestrieri, G., Tincani, A., Spatola, L., Allegri, F., Prati, E., Cattaneo, R., Valesini, G., Papa, N. D., & Meroni, P. L. (1995) · Lupus · doi:10.1177/096120339500400208 · Cited by 153 · see citing works
Self-citationAntimalarial agents: Closing the gate on toll‐like receptors?
Lafyatis, R., York, M. R., & Marshak‐Rothstein, A. (2006) · Arthritis & Rheumatism · doi:10.1002/art.22157 · Cited by 152 · see citing works
Borba, E. F., & Bonfá, E. (2001) · PubMed · Cited by 145 · see citing works
Hydroxychloroquine Compared with Placebo in Rheumatoid Arthritis
Clark, P., Casas, E., Tugwell, P., Medina, C., Gheno, C., Tenorio, G., & Orozco, J. A. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-119-11-199312010-00002 · Cited by 140 · see citing works
Kyburz, D., Brentano, F., & Gay, S. (2006) · Nature Clinical Practice Rheumatology · doi:10.1038/ncprheum0292 · Cited by 136 · see citing works
Molad, Y., Gorshtein, A., Wysenbeek, A. J., Guedj, D., Majadla, R., Weinberger, A., & Amit-Vazina, M. (2002) · Lupus · doi:10.1191/0961203302lu203ra · Cited by 134 · see citing works
Antithrombotic effects of hydroxychloroquine in primary antiphospholipid syndrome patients
Schmidt‐Tanguy, A., Voswinkel, J., Henrion, D., Subra, J. F., Loufrani, L., Rohmer, V., Ifrah, N., & Belizna, C. (2013) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.12363 · Cited by 132 · see citing works
Tincani, A., Allegri, F., Balestrieri, G., Reber, G., Sanmarco, M., Meroni, P. L., & Boffa, M. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.06.035 · Cited by 128 · see citing works
Self-citationHo, K. T., Ahn, C. W., Alarcón, G. S., Baethge, B. A., Tan, F. K., Roseman, J., Bastian, H. M., Fessler, B. J., McGwin, G., Vilá, L. M., et al. (2005) · Rheumatology · doi:10.1093/rheumatology/kei014 · Cited by 128 · see citing works
Does hydroxychloroquine sulfate prevent clot formation in systemic lupus erythematosus?
Wallace, D. J. (1987) · Arthritis & Rheumatism · doi:10.1002/art.1780301219 · Cited by 124 · see citing works
Platelet-Inhibiting Drugs in the Prevention of Clinical Thrombotic Disease
Genton, E., Gent, M., Hirsh, J., et al. (1975) · New England Journal of Medicine · doi:10.1056/nejm197512042932305 · Cited by 111 · see citing works
Wallace, D. J., Linker‐Israeli, M., METZGER, A. L., & Stecher, V. J. (1993) · Lupus · doi:10.1177/0961203393002001041 · Cited by 111 · see citing works
BRODER, A., & PUTTERMAN, C. (2013) · The Journal of Rheumatology · doi:10.3899/jrheum.120157 · Cited by 101 · see citing works
The efficacy of antimalarials in systemic lupus erythematosus.
Nayak, V., & Esdaile, J. M. (1993) · PubMed · Cited by 98 · see citing works
On the inhibitory effect of chloroquine on blood platelet aggregation
Jančinová, V., Nosál, R., & Petríková, M. (1994) · Thrombosis Research · doi:10.1016/0049-3848(94)90270-4 · Cited by 85 · see citing works
The Clinical Significance of Autoantibody Profiles in Patients with Systemic Lupus Erythematosus
Thompson, D., Juby, A. G., & Davis, P. J. (1993) · Lupus · doi:10.1177/096120339300200104 · Cited by 84 · see citing works
Martin, A., & Reichlin, M. (1996) · Lupus · doi:10.1177/096120339600500106 · Cited by 82 · see citing works
Antinucleosome antibodies in primary antiphospholipid syndrome: A hint at systemic autoimmunity?
Andréoli, L., Pregnolato, F., Burlingame, R. W., Allegri, F., Rizzini, S., Fanelli, V., Radice, A., Corace, C., Sinico, R. A., Meroni, P. L., et al. (2008) · Journal of Autoimmunity · doi:10.1016/j.jaut.2007.11.004 · Cited by 60 · see citing works
Self-citationMetabolism of chloroquine and hydroxychloroquine in albino and pigmented rats
McChesney, E. W., Banks, W. F., & Sullivan, D. (1965) · Toxicology and Applied Pharmacology · doi:10.1016/0041-008x(65)90050-5 · Cited by 60 · see citing works
Lombard-Platlet, S., Bertolino, P., Deng, H., et al. (1993) · PubMed · Cited by 55 · see citing works
Antiphospholipid Syndrome Clinical Research Task Force Report
Erkan, D., Derksen, R. H. W. M., Levy, R. A., Machin, S. J., Ortel, T. L., Pierangeli, S. S., Roubey, R. A. S., & Lockshin, M. D. (2011) · Lupus · doi:10.1177/0961203310395053 · Cited by 42 · see citing works
Platelet-Inhibiting Drugs in the Prevention of Clinical Thrombotic Disease
Genton, E., Gent, M., Hirsh, J., et al. (1975) · New England Journal of Medicine · doi:10.1056/nejm197512182932506 · Cited by 30 · see citing works
Hydroxychloroquine treatment of rheumatoid arthritis
Rynes, R. I. (1988) · The American Journal of Medicine · doi:10.1016/0002-9343(88)90357-9 · Cited by 27 · see citing works
APS—More Systemic Disease than SLE
Shoenfeld, Y. (2007) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-007-0005-z · Cited by 24 · see citing works
The efficacy of antimalarials in systemic lupus erythematosus
Nayak, V., & Jm, E. (1996) · Lupus · doi:10.1177/0961203396005001061 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Mechanisms of action of hydroxychloroquine and chloroquine:implications for rheumatology
Schrezenmeier, E., & Dörner, T. (2020) · Nature Reviews Rheumatology · doi:10.1038/s41584-020-0372-x · Cited by 1,468 · see citing works
Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome
Pengo, V., Denas, G., Zoppellaro, G., Jose, S. P., Hoxha, A., Ruffatti, A., Andreoli, L., Tincani, A., Cenci, C., Prisco, D., et al. (2018) · Blood · doi:10.1182/blood-2018-04-848333 · Cited by 822 · see citing works
Self-citationOrdi-Ros, J., Sáez-Comet, L., Pérez-Conesa, M., Vidal, X., Riera-Mestre, A., Castro-Salomó, A., Cuquet-Pedragosa, J., Ortiz-Santamaria, V., Mauri-Plana, M., Solé, C., et al. (2019) · Annals of Internal Medicine · doi:10.7326/m19-0291 · Cited by 324 · see citing works
Diagnosis and management of the antiphospholipid syndrome
Chaturvedi, S., & McCrae, K. R. (2017) · Blood Reviews · doi:10.1016/j.blre.2017.07.006 · Cited by 191 · see citing works
McDonnell, T. C. R., Wincup, C., Buchholz, I., Pericleous, C., Giles, I., Ripoll, V. M., Cohen, H., Delcea, M., & Rahman, A. (2019) · Blood Reviews · doi:10.1016/j.blre.2019.100610 · Cited by 169 · see citing works
Quirós-Roldán, E., Biasiotto, G., Magro, P., & Zanella, I. (2020) · Pharmacological Research · doi:10.1016/j.phrs.2020.104904 · Cited by 153 · see citing works
Cohen, H., Cuadrado, M. J., Erkan, D., Duarte‐García, A., Isenberg, D. A., Knight, J. S., Ortel, T. L., Rahman, A., Salmon, J. E., Tektonidou, M. G., et al. (2020) · Lupus · doi:10.1177/0961203320950461 · Cited by 165 · see citing works
Hydroxychloroquine: An old drug with new relevance
Shippey, E. A., Wagler, V. D., & Collamer, A. N. (2018) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.85a.17034 · Cited by 139 · see citing works
Cardiovascular disease risk in antiphospholipid syndrome: Thrombo-inflammation and atherothrombosis
Tektonidou, M. G. (2022) · Journal of Autoimmunity · doi:10.1016/j.jaut.2022.102813 · Cited by 122 · see citing works
Kravvariti, E., Koutsogianni, A., Samoli, E., Sfikakis, P. P., & Tektonidou, M. G. (2020) · Autoimmunity Reviews · doi:10.1016/j.autrev.2020.102491 · Cited by 112 · see citing works
Petri, M. (2020) · Translational research · doi:10.1016/j.trsl.2020.04.006 · Cited by 101 · see citing works
Sevim, E., Zisa, D., Andrade, D., Sciascia, S., Pengo, V., Tektonidou, M. G., Ugarte, A., Gerosa, M., Belmont, H. M., Zamorano, M. A. A., et al. (2022) · Arthritis Care & Research · doi:10.1002/acr.24468 · Cited by 88 · see citing works
Self-citationBelizna, C. C., Pregnolato, F., Abad, S., Alijotas‐Reig, J., Amital, H., Amoura, Z., Andréoli, L., Andrès, E., Aouba, A., Bilgen, Ş. A., et al. (2018) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.05.012 · Cited by 78 · see citing works
Self-citationThe treatment of anti-phospholipid syndrome: A comprehensive clinical approach
Chighizola, C. B., Andréoli, L., Gerosa, M., Tincani, A., Ruffatti, A., & Meroni, P. L. (2018) · Journal of Autoimmunity · doi:10.1016/j.jaut.2018.02.003 · Cited by 66 · see citing works
Self-citationPalli, E., Kravvariti, E., & Tektonidou, M. G. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00487 · Cited by 61 · see citing works
Ünlü, O., Erkan, D., Barbhaiya, M., ANDRADE, D. C. O. D., Nascimento, I. S., Rosa, R. F., Banzato, A., Pengo, V., Ugarte, A., Gerosa, M., et al. (2018) · Arthritis Care & Research · doi:10.1002/acr.23584 · Cited by 60 · see citing works
Self-citationAn update on the management of antiphospholipid syndrome
Rodziewicz, M., & D’Cruz, D. P. (2020) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x20910855 · Cited by 59 · see citing works
Hydroxychloroquine as an Immunomodulatory and Antithrombotic Treatment in Antiphospholipid Syndrome
Arachchillage, D. J., Laffan, M., & Pericleous, C. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24021331 · Cited by 53 · see citing works
New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations
Sakowicz, A., Bralewska, M., Rybak-Krzyszkowska, M., Grzesiak, M., & Pietrucha, T. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241512100 · Cited by 51 · see citing works
Hydroxychloroquine in systemic and autoimmune diseases: Where are we now?
Dima, A., Jurcuț, C., & Arnaud, L. (2021) · Joint Bone Spine · doi:10.1016/j.jbspin.2021.105143 · Cited by 48 · see citing works
Antiphospholipid syndrome: state of the art on clinical practice guidelines
Limper, M., Scirè, C. A., Talarico, R., Amoura, Z., Avčin, T., Basile, M., Burmester, G. R., Carli, L., Cervera, R., Costedoat-Chalumeau, N., et al. (2018) · RMD Open · doi:10.1136/rmdopen-2018-000785 · Cited by 50 · see citing works
Self-citationMeroni, P. L., & Borghi, M. O. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.726820 · Cited by 46 · see citing works
Self-citationMinno, M. N. D. D., Emmi, G., Ambrosino, P., Scalera, A., Tufano, A., Cafaro, G., Peluso, R., Bettiol, A., Scala, G. D., Silvestri, E., et al. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.06.010 · Cited by 38 · see citing works
Coronavirus disease 2019 (COVID-19) and autoimmunity
Nasonov, E. L. (2021) · Rheumatology Science and Practice · doi:10.47360/1995-4484-2021-5-30 · Cited by 40 · see citing works
Diagnostics and treatment of thrombotic antiphospholipid syndrome (APS): A personal perspective
Pengo, V., & Denas, G. (2018) · Thrombosis Research · doi:10.1016/j.thromres.2018.07.011 · Cited by 37 · see citing works
Self-citationPediatric APS: State of the Art
Soybilgic, A., & Avčin, T. (2020) · Current Rheumatology Reports · doi:10.1007/s11926-020-0887-9 · Cited by 36 · see citing works
Treatment of antiphospholipid syndrome beyond anticoagulation
Dobrowolski, C., & Erkan, D. (2018) · Clinical Immunology · doi:10.1016/j.clim.2018.03.001 · Cited by 35 · see citing works
How I treat anticoagulant-refractory thrombotic antiphospholipid syndrome
Cohen, H., & Isenberg, D. A. (2020) · Blood · doi:10.1182/blood.2020004942 · Cited by 35 · see citing works
Immune Thrombocytopenia in Antiphospholipid Syndrome: Is It Primary or Secondary?
Tomasello, R., Giordano, G., Romano, F., et al. (2021) · Biomedicines · doi:10.3390/biomedicines9091170 · Cited by 35 · see citing works
Preeclampsia and the Antiphospholipid Syndrome
Mayer-Pickel, K. I., Nanda, M., Gajić, M., & Cervar-Zivkovic, M. (2023) · Biomedicines · doi:10.3390/biomedicines11082298 · Cited by 33 · see citing works
Treatment of antiphospholipid syndrome
Radin, M., Cecchi, I., Rubini, E., Foddai, S. G., Barinotti, A., Menegatti, E., Roccatello, D., & Sciascia, S. (2020) · Clinical Immunology · doi:10.1016/j.clim.2020.108597 · Cited by 31 · see citing works
Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center
Serrano, R., Pons‐Estel, G., Espinosa, G., Quintana, R., Reverter, J. C., Tàssies, D., Monteagudo, J., & Cervera, R. (2020) · Lupus · doi:10.1177/0961203320933009 · Cited by 31 · see citing works
Tufano, A., Minno, M. N. D. D., Guida, A., Lembo, M., Minno, G. D., & Galderisi, M. (2019) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0039-1692702 · Cited by 31 · see citing works
Cheng, C., Cheng, G.-Y., Denas, G., & Pengo, V. (2020) · Blood Reviews · doi:10.1016/j.blre.2020.100788 · Cited by 31 · see citing works
Self-citationBendjeffal, H., Ziati, M., Aloui, A., et al. (2021) · International Journal of Environmental & Analytical Chemistry · doi:10.1080/03067319.2021.1887162 · Cited by 31 · see citing works
Karakasis, P., Patoulias, D., Stachteas, P., Lefkou, E. E., Dimitroulas, T., & Fragakis, N. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.101999 · Cited by 31 · see citing works
Kamat, S., & Kumari, M. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.576093 · Cited by 28 · see citing works
Dilemmas in the diagnosis and management of antiphospholipid syndrome
Manning, J. E., & Arachchillage, D. J. (2024) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2024.03.027 · Cited by 30 · see citing works
Update on Antiphospholipid Syndrome: Ten Topics in 2017
Cavazzana, I., Andréoli, L., Limper, M. A., Franceschini, F., & Tincani, A. (2018) · Current Rheumatology Reports · doi:10.1007/s11926-018-0718-4 · Cited by 28 · see citing works
Self-citationProtection by hydroxychloroquine prevents placental injury in obstetric antiphospholipid syndrome
Liu, J., Zhang, L., Tian, Y., et al. (2022) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.17459 · Cited by 27 · see citing works
Karakasis, P., Lefkou, E. E., Pamporis, K., Nevras, V., Bougioukas, K. I., Haidich, A., & Fragakis, N. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.101672 · Cited by 27 · see citing works
Emmi, G., Bettiol, A., Palterer, B., Silvestri, E., Vitiello, G., Parronchi, P., & Prisco, D. (2019) · Autoimmunity Reviews · doi:10.1016/j.autrev.2018.11.002 · Cited by 27 · see citing works
Cáliz, R., Fontecha, P. D. D. C., Galindo-Izquierdo, M., Longo, F. J. L., Zamora, M. Á. M., Santamaría, A., Pliego, O. A., Lozano, M. J. C., Beltrán, M. P. D., Carmona, L., et al. (2019) · Reumatología Clínica · doi:10.1016/j.reuma.2018.11.003 · Cited by 26 · see citing works
Solid Phase Assays for Antiphospholipid Antibodies
Devreese, K. M. J. (2022) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0042-1744364 · Cited by 27 · see citing works
Thrombosis and antiphospholipid antibody syndrome during acute Q fever
Million, M., Bardin, N., Bessis, S., Nouiakh, N., Douliery, C., Edouard, S., Angelakis, E., Bosseray, A., Épaulard, O., Branger, S., et al. (2017) · Medicine · doi:10.1097/md.0000000000007578 · Cited by 26 · see citing works
Bundhun, P. K., Soogund, M. Z. S., & Huang, F. (2018) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-018-1850-x · Cited by 26 · see citing works
Friedberg, E., Wohlfarth, P., Schiefer, A. I., Skrabs, C., Pickl, W. F., Worel, N., Staber, P. B., Jaeger, U., & Ay, C. (2024) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2024.09.024 · Cited by 25 · see citing works
What is the appropriate anticoagulation strategy for thrombotic antiphospholipid syndrome?
Arachchillage, D. J., & Laffan, M. (2020) · British Journal of Haematology · doi:10.1111/bjh.16431 · Cited by 23 · see citing works
Garg, S., Chewning, B. A., Hutson, P. R., Astor, B. C., & Bartels, C. M. (2023) · Arthritis Care & Research · doi:10.1002/acr.25228 · Cited by 27 · see citing works
Fierro, J. J., Velásquez, M., Ospina, A., Henning, S., de Leeuw, K., & J, Á. P. C. (2023) · Rheumatology International · doi:10.1007/s00296-023-05457-5 · Cited by 24 · see citing works
Medina, G., Cimé‐Aké, E., Lastra, O. L. V., et al. (2020) · Lupus · doi:10.1177/0961203320970651 · Cited by 22 · see citing works
Madison, J. A., Gockman, K., Hoy, C. K., et al. (2022) · Pediatric Rheumatology · doi:10.1186/s12969-022-00677-8 · Cited by 21 · see citing works
Chighizola, C. B., Pregnolato, F., ANDRADE, D. C. O. D., Tektonidou, M. G., Pengo, V., Ruiz‐Irastorza, G., Belmont, M. H., Gerosa, M., Fortin, P. R., Branch, D. W., et al. (2023) · Arthritis & Rheumatology · doi:10.1002/art.42459 · Cited by 22 · see citing works
Self-citationRadin, M., Schreiber, K. I., Sciascia, S., Roccatello, D., Cecchi, I., Aguirre, M. A., & Cuadrado, M. J. (2019) · Thrombosis and Haemostasis · doi:10.1055/s-0039-1696687 · Cited by 21 · see citing works
Zen, M., Loredo Martinez, M., Benvenuti, F., Gatto, M., Saccon, F., Larosa, M., Iaccarino, L., & Doria, A. (2021) · Rheumatology · doi:10.1093/rheumatology/keaa463 · Cited by 19 · see citing works
Thrombotic risk factors in patients with antiphospholipid syndrome: a single center experience
Abu-Zeinah, G. F., Oromendia, C., & DeSancho, M. T. (2019) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-019-01836-7 · Cited by 16 · see citing works
Towards precision medicine in antiphospholipid syndrome
López-Pedrera, C., Pérez-Sánchez, C., & Tektonidou, M. G. (2025) · The Lancet Rheumatology · doi:10.1016/s2665-9913(25)00094-3 · Cited by 16 · see citing works
κ-Carrageenan/Sodium Alginate: A New Synthesis Route and Rapid Adsorbent for Hydroxychloroquine Drug
Al-Hussainawy, M. K., & Jasim, L. S. (2023) · Indonesian Journal of Chemistry · doi:10.22146/ijc.76819 · Cited by 15 · see citing works
Diagnostic biologique du syndrome des antiphospholipides : des critères à la pratique
Joste, V., Dragon‐Durey, M., & Darnige, L. (2017) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2017.02.006 · Cited by 15 · see citing works
Management of anticoagulant-refractory thrombotic antiphospholipid syndrome
Cohen, H., Sayar, Z., Efthymiou, M., Gaspar, P., Richards, T., & Isenberg, D. A. (2020) · The Lancet Haematology · doi:10.1016/s2352-3026(20)30116-2 · Cited by 15 · see citing works
Frodlund, M., Walhelm, T., Dahle, C., et al. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.646846 · Cited by 14 · see citing works
Wu, T., Huang, W., Qi, J., Li, Y., Zhang, Y., Jiang, H., Wang, J., Zhang, J., Jiang, Z.-Y., Chen, L., et al. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.1035229 · Cited by 13 · see citing works
Bettiol, A., Pregnolato, F., Sciascia, S., et al. (2022) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2020-218377 · Cited by 14 · see citing works
Self-citationTian, Y., Xu, J., Chen, D., Yang, C., & Peng, B. (2021) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2021.102121 · Cited by 13 · see citing works
Thrombosis and Anti-phospholipid Syndrome: a 5-Year Update on Treatment
Chighizola, C. B., & Meroni, P. L. (2018) · Current Rheumatology Reports · doi:10.1007/s11926-018-0741-5 · Cited by 13 · see citing works
Self-citationStroke and Risk Factors in Antiphospholipid Syndrome
Fan, Y., Xu, Y., Zhang, S., et al. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm14010024 · Cited by 12 · see citing works
Deciphering the clinical significance of longitudinal antiphospholipid antibody titers
Chighizola, C. B., Willis, R., Maioli, G., Sciascia, S., Andréoli, L., Amengual, O., Radin, M., Gerosa, M., Atsumi, T., de Jesús, G. R., et al. (2024) · Autoimmunity Reviews · doi:10.1016/j.autrev.2023.103510 · Cited by 15 · see citing works
Self-citationGajić, M., Schröder‐Heurich, B., & Mayer-Pickel, K. I. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1298928 · Cited by 14 · see citing works
Brady, C. A., Ford, L. B., Moss, C., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-69315-5 · Cited by 12 · see citing works
Clinical profiles and risk assessment in patients with antiphospholipid antibodies
Kato, M., Hisada, R., & Atsumi, T. (2018) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2019.1543025 · Cited by 12 · see citing works
Beta-2-glycoprotein-I IgA antibodies predict coronary plaque progression in rheumatoid arthritis
Karpouzas, G. A., Ormseth, S. R., Hernández, E., et al. (2020) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2020.10.003 · Cited by 11 · see citing works
Neurologic Manifestations of Catastrophic Antiphospholipid Syndrome
Mustafa, R. (2022) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-022-01228-0 · Cited by 10 · see citing works
Nasonov, E. L. (2024) · Rheumatology Science and Practice · doi:10.47360/1995-4484-2024-32-54 · Cited by 12 · see citing works
Treatment of thrombotic antiphospholipid syndrome in adults and children
Madison, J. A., Duarte‐García, A., Zuo, Y., & Knight, J. S. (2020) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000702 · Cited by 12 · see citing works
Cardiovascular disease and antiphospholipid syndrome: how to predict and how to treat?
Calcaterra, I. L., Tufano, A., Lupoli, R., Iannuzzo, G., Emmi, G., & Minno, M. N. D. D. (2020) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.15415 · Cited by 12 · see citing works
Saleh, Z., Somers, E. C., Romero, V., & Marder, W. (2025) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2025.09.002 · Cited by 11 · see citing works
Garg, S., Astor, B. C., Saric, C., Valiente, G. R., Kolton, L., Chewning, B. A., & Bartels, C. M. (2024) · Arthritis Care & Research · doi:10.1002/acr.25422 · Cited by 10 · see citing works
Liu, M., Li, G., Song, X., Fan, Y., & Li, C. (2023) · Scientific Reports · doi:10.1038/s41598-023-35955-2 · Cited by 10 · see citing works
Can hydroxychloroquine be protective against COVID-19-associated thrombotic events ?
Devaux, C. A., Camoin‐Jau, L., Mège, J., & Raoult, D. (2021) · Journal of Microbiology Immunology and Infection · doi:10.1016/j.jmii.2020.12.010 · Cited by 9 · see citing works
The clinical significance of antiphospholipid antibodies in COVID-19 infection
Atalar, E., Erden, A., Güven, S. C., Armağan, B., Ateş, İ., Küçükşahin, O., & Omma, A. (2022) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.15423 · Cited by 9 · see citing works
Antiphospholipid Syndrome in Patients with Venous Thromboembolism
Pengo, V., & Denas, G. (2022) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0042-1749590 · Cited by 8 · see citing works
Self-citationGarg, S., Ferguson, S., Chewning, B. A., Gomez, S., Keevil, J. G., & Bartels, C. M. (2023) · Lupus Science & Medicine · doi:10.1136/lupus-2023-000935 · Cited by 8 · see citing works
Hydroxychloroquine reduces T cells activation recall antigen responses
Kowatsch, M. M., Lajoie, J., Mwangi, L. W., Omollo, K., Oyugi, J. O., Hollett, N. A., Kimani, J., & Fowke, K. R. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287738 · Cited by 6 · see citing works
Antiphospholipid antibodies as potential prognostic indicators of recurrent ischemic stroke
Geng, L., Pan, K., Xu, Y., Zhang, B., Wang, J., Xue, Q., Zhang, S., Su, H., & Zhang, B. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107885 · Cited by 7 · see citing works
Antiphospholipid syndrome in cardiovascular disease and cancer
Pessach, I., Kyriakou, E. S., Kalampokas, E., Kalampokas, T., Bitsani, A., & Kotsianidis, Ι. (2023) · European Journal Of Haematology · doi:10.1111/ejh.14096 · Cited by 5 · see citing works
Elbagir, S., Elshafie, A., Elagib, E. M., Mohammed, N. A., Aledrissy, M., Manivel, V. A., Pertsinidou, E., Nur, M. A., Gunnarsson, I., Svenungsson, E., et al. (2020) · Lupus · doi:10.1177/0961203320945387 · Cited by 5 · see citing works
Lewis, K., Tambralli, A., & Madison, J. A. (2025) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000001083 · Cited by 6 · see citing works
Urrego-Callejas, T., Hernández, A., Giraldo, S. R., Frade‐Sosa, B., Vanegas-García, A. L., Muñoz, C. H., Rúa, C., Botero, J. D., González, L. A., Vásquez, G. M., et al. (2022) · Reumatología Clínica · doi:10.1016/j.reuma.2022.07.003 · Cited by 4 · see citing works
COVID-19 Coagulopathy in a Patient With Systemic Lupus Erythematosus and Antiphospholipid Antibodies
Freeman-Beman, L., Ratner, S., Kabani, N., et al. (2020) · JCR Journal of Clinical Rheumatology · doi:10.1097/rhu.0000000000001599 · Cited by 4 · see citing works
Santos, G. M., David, P., Hen, O., Ontiveros-Austria, J. L., Liran, R., Rodríguez‐Rodríguez, S., de Godói, J. C., Patt, Y. S., Beladev, S., Okazaki, E., et al. (2025) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2025.06.010 · Cited by 3 · see citing works
Chatzidionysiou, K., Samoli, E., Sfikakis, P. P., & Tektonidou, M. G. (2020) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2020-218444 · Cited by 3 · see citing works
Omma, A., Erden, A., Apaydın, H., et al. (2022) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.14933 · Cited by 3 · see citing works
Urrego-Callejas, T., Hernández, A., Giraldo, S. R., Frade‐Sosa, B., Vanegas-García, A. L., Muñoz, C. H., Rúa, C., Botero, J. D., González, L. A., Vásquez, G. M., et al. (2023) · Reumatología Clínica (English Edition) · doi:10.1016/j.reumae.2023.01.001 · Cited by 3 · see citing works
Viewpoint: Provoked thrombosis in antiphospholipid syndrome
Wahl, D. G., & Pengo, V. (2024) · Rheumatology · doi:10.1093/rheumatology/kead675 · Cited by 3 · see citing works
Self-citationHidroxicloroquina: Del fármaco de herencia Inca hasta la inmunología moderna
Alfaro-Murillo, A., & Bratti, M. P. L. (2020) · Acta Médica Costarricense · doi:10.51481/amc.v62i2.1062 · Cited by 3 · see citing works
Capucci, A., Santarelli, A., Bartolomei, M., et al. (2020) · Journal of Cardiovascular Medicine · doi:10.2459/jcm.0000000000001061 · Cited by 3 · see citing works
aPLs seroconversion in antiphospholipid syndrome: from definition to clinical relevance
Giorgio, A. D., Carnuccio, C., Nesci, A., Stefano, V. D., & Santoliquido, A. (2026) · Thrombosis Research · doi:10.1016/j.thromres.2026.109622 · Cited by 2 · see citing works
Khayyat, S., Ebrahem, R., Al-Hadeethi, D., et al. (2019) · Kansas Journal of Medicine · doi:10.17161/kjm.v12i1.11706 · Cited by 2 · see citing works
Perricone, C., & Valesini, G. (2016) · Immunologic Research · doi:10.1007/s12026-016-8857-z · Cited by 2 · see citing works
Cassia, M. A., & Alberici, F. (2018) · Lara D. Veeken · doi:10.1093/rheumatology/key407 · Cited by 2 · see citing works
- Authors
- Nuri, E., Taraborelli, M., Andreoli, L., Tonello, M., Gerosa, M., Calligaro, A., Argolini, L. M., Kumar, R., Pengo, V., Meroni, P. L., Ruffatti, A., & Tincani, A.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- University of Padua (IT)
- University of Milan (IT)
- ORCID
- Venue
- Immunologic Research
- Published
- 2016-07-13
- Volume
- 65
- Issue
- 1
- Pages
- 17-24
- ISSN
- 0257-277X (ISSN-L)
- 1559-0755
- OpenAlex
- W2460218540
- Semantic Scholar
- 7a1185c5b341f66380f80a3cce640b70c57dc651
- Cited by
- 124
- References
- 41
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 13 · 2023: 15 · 2022: 12 · 2021: 12 · 2020: 27 · 2019: 13 · 2018: 14 · 2017: 3 · 2016: 1
- FWCI
- 9.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Immunologic Research (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Keywords
- hydroxychloroquine, primary antiphospholipid syndrome, antiphospholipid antibodies, anti-beta2-glycoprotein I antibodies, anticardiolipin antibodies, recurrent thrombosis, arterial thrombosis, long-term drug therapy
- MeSH terms
- Adult, Antibodies, Antinuclear, Blood Glucose, Cholesterol, Female, Humans, Hydroxychloroquine, Immunoglobulin G
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
