Hydroxychloroquine in the primary thrombosis prophylaxis of antiphospholipid antibody positive patients without systemic autoimmune disease
Abstract
Objective: The objective of this study was to determine the efficacy of hydroxychloroquine (HCQ) in the primary thrombosis prevention of antiphospholipid antibody (aPL)-positive patients with no other systemic autoimmune diseases. Methods: Under the auspices of Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking, a multicenter, international, randomized controlled trial (RCT) was initiated, in which persistently aPL-positive but thrombosis-free patients without systemic autoimmune diseases were randomized to receive HCQ or no treatment in addition to their standard regimen. The primary objective was the efficacy of HCQ in preventing the first thrombosis. The secondary objectives were the thrombosis incidence rate, and the effects of HCQ on aPL profile and mortality rate. Patients were risk-stratified based on antiplatelet agent use. The goal was to follow patients every 6 months for 5 years. Results: We recruited 20 persistently aPL-positive patients (female: 19, mean age: 46.6 ± 9.9 years, and baseline antiplatelet medication: 14); 9/20 were randomized to HCQ. During the mean follow-up of 1.7 years, no patients developed thrombosis or a serious adverse event. The study was terminated early due to the low recruitment rate, exacerbated by the prolonged manufacturing shortage and significant price increase of HCQ in the United States. Conclusion: Given that a small number of patients with a relatively short follow-up were enrolled in our RCT, and no patients developed thrombosis, we cannot accurately assess the effectiveness of HCQ for primary thrombosis prevention in persistently aPL-positive patients with no other systemic autoimmune diseases. Our experience suggests that conducting an international RCT, especially without pharmaceutical support, is an extremely challenging undertaking.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.08.010 · Cited by 51,384 · see citing works
Hochberg, M. C. (1997) · Arthritis & Rheumatism · doi:10.1002/art.1780400928 · Cited by 11,409 · see citing works
Aletaha, D., Neogi, T., Silman, A. J., Funovits, J., Felson, D. T., Bingham, C. O., Birnbaum, N. S., Burmester, G. R., Bykerk, V. P., Cohen, M. D., et al. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27584 · Cited by 9,631 · see citing works
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-citationOptimal two-stage designs for phase II clinical trials.
Simon, R. (1989) · Controlled Clinical Trials · doi:10.1016/0197-2456(89)90015-9 · Cited by 3,636 · see citing works
van den Hoogen, F. H. J., Khanna, D., Fransen, J., Johnson, S. R., Baron, M. G., Tyndall, A., Matucci‐Cerinic, M., Naden, R. P., Medsger, T. A., Carreira, P. E., et al. (2013) · Arthritis & Rheumatism · doi:10.1002/art.38098 · Cited by 3,399 · see citing works
Shiboski, S. C., Shiboski, C. H., Criswell, L. A., Baer, A. N., Challacombe, S., Lanfranchi, H. E., Schiødt, M., Umehara, H., Vivino, F. B., Zhao, Y., et al. (2012) · Arthritis Care & Research · doi:10.1002/acr.21591 · Cited by 1,355 · see citing works
Kirby, R. S. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.01.010 · Cited by 681 · see citing works
Pengo, V., Ruffatti, A., Legnani, C., Testa, S., Fierro, T., Marongiu, F., De Micheli, V., Gresele, P., Tonello, M., Ghirarduzzi, A., et al. (2011) · Blood · doi:10.1182/blood-2011-03-340232 · Cited by 465 · see citing works
Finazzi, G., Brancaccio, V., Moia, M., Ciavarella, N., Mazzucconi, M. G., Schinco, P., Ruggeri, M., Pogliani, E. M., Gamba, G., Rossi, E., et al. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(96)00060-5 · Cited by 427 · see citing works
Effect 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
Erkan, D., Harrison, M. J., Levy, R., Peterson, M., Petri, M., Sammaritano, L., Unalp‐Arida, A., Vilela, V., Yazici, Y., & Lockshin, M. D. (2007) · Arthritis & Rheumatism · doi:10.1002/art.22663 · Cited by 401 · see citing works
Self-citationTektonidou, M. G., Laskari, K., Panagiotakos, D. B., & Moutsopoulos, H. M. (2009) · Arthritis Care & Research · doi:10.1002/art.24232 · Cited by 356 · see citing works
Self-citationHydroxychloroquine 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
Rand, J. H., Wu, X.-X., Quinn, A. S., Ashton, A. W., Chen, P. P., Hathcock, J. J., Andree, H. A. M., & Taatjes, D. J. (2010) · Blood · doi:10.1182/blood-2009-04-213520 · Cited by 253 · see citing works
Hydroxychloroquine Reverses Thrombogenic Properties of Antiphospholipid Antibodies in Mice
Edwards, M. H., Pierangeli, S., Liu, X., Barker, J. H., Anderson, G., & Harris, E. N. (1997) · Circulation · doi:10.1161/01.cir.96.12.4380 · Cited by 250 · 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
(2004) · PubMed · Cited by 218 · see citing works
Outcome of patients with anticardiolipin antibodies: a 10 year follow-up of 52 patients
Shah, N. M., Khamashta, M. A., Atsumi, T., & Hughes, G. R. (1998) · Lupus · doi:10.1191/096120398678919624 · Cited by 204 · see citing works
(2002) · PubMed · Cited by 191 · see citing works
A prospective study of antibodies to β2‐glycoprotein I and prothrombin, and risk of thrombosis
FORASTIERO, R., MARTINUZZO, M., POMBO, G., PUENTE, D., ROSSI, A., CELEBRIN, L., BONACCORSO, S., & AVERSA, L. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01295.x · Cited by 170 · see citing works
(1994) · PubMed · Cited by 116 · see citing works
Self-citationRuffatti, A., Ross, T. D., Ciprian, M., Nuzzo, M., Rampudda, M., Bertero, M. T., Bergia, R., Caramaschi, P., Biasi, D., Capsoni, F., et al. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.096669 · Cited by 106 · see citing works
Tarr, T., Lakos, G., Bhattoa, H. P., Shoenfeld, Y., Szegedi, G., & Kiss, E. (2007) · Lupus · doi:10.1177/0961203306074767 · Cited by 88 · see citing works
Influence of aspirin on the clinical outcomes of 103 anti-phospholipid antibodies-positive patients
Hereng, T., Lambert, M., HACHULLA, E., Samor, M., Dubucquoi, S., Caron, C., Launay, D., Morell‐Dubois, S., Queyrel, V., & Hatron, P. (2007) · Lupus · doi:10.1177/0961203307084724 · Cited by 84 · see citing works
Recurrent miscarriage and long-term thrombosis risk: a case–control study
Quenby, S. M., Farquharson, R. G., Dawood, F. A., Hughes, A. M., & Topping, J. (2005) · Human Reproduction · doi:10.1093/humrep/deh844 · Cited by 84 · see citing works
APS ACTION – AntiPhospholipid Syndrome Alliance For Clinical Trials and InternatiOnal Networking
Erkan, D., & Lockshin, M. (2012) · Lupus · doi:10.1177/0961203312437810 · Cited by 61 · see citing works
Self-citationLupus in Baltimore: evidence-based ‘clinical pearls’ from the Hopkins Lupus Cohort
Petri, M. (2005) · Lupus · doi:10.1191/0961203305lu2230xx · Cited by 52 · see citing works
Clark, A. R., Dean, J. L. E., & Saklatvala, J. (2009) · Arthritis & Rheumatism · doi:10.1002/art.24919 · Cited by 34 · see citing works
Zandvliet, A. S., Karlsson, M. O., Schellens, J. H. M., Copalu, W., Beijnen, J. H., & Huitema, A. D. R. (2009) · Investigational New Drugs · doi:10.1007/s10637-008-9216-2 · Cited by 13 · see citing works
ACTION, O. B. O. A., Barbhaiya, M., ANDRADE, D. C. O. D., et al. (2016) · Current Rheumatology Reports · doi:10.1007/s11926-016-0611-y · Cited by 12 · see citing works
Self-citationPope (2001) · doi:10.1002/1529-0131(200106)44:6
Self-citation
Flagged first, then by citations
1 of the 33 references couldn’t be matched to a known paper.
Research works printed but not linked: 4
- Giron-Gonzalez JA, 2004, J Rheumatol, 31, 1560
- Somers E, 2002, J Rheumatol, 29, 2531
- Silver RM, 1994, Obstet Gynecol, 83, 372
- Guyatt G, Drummond R, Meade M, Cook D. The evidence-based medicine working group. In: Users’ guides to the medical literature. Essentials of evidence-based clinical practice . Chicago, IL: McGraw Hill Education, 2008.
Cited by
Sorted by citations
EULAR recommendations for the management of antiphospholipid syndrome in adults
Tektonidou, M. G., Andreoli, L., Limper, M., Amoura, Z., Cervera, R., Costedoat-Chalumeau, N., Cuadrado, M. J., Dörner, T., Ferrer-Oliveras, R., Hambly, K., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-215213 · Cited by 1,261 · see citing works
Self-citationSammaritano, L. R. (2019) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2019.101463 · Cited by 201 · 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
“Unfortunately the study was terminated early due to low recruitment rates and the authors concluded that the efficacy of HCQ in these cases could not be fully assessed, thus highlighting the challenges of achieving reduced thrombosis as a primary outcome in clinical trials in APS [225].”
ResultCohen, 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
“The authors concluded that conducting an international RCT without pharmaceutical industry support is extremely challenging.(66)”
BackgroundSelf-citationKravvariti, 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
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
The 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
“In addition, the authors suggested that conducting an international RCT, especially without pharmaceutical support, is an extremely challenging undertaking [265].”
BackgroundAntiphospholipid syndrome management: a 2023 update and practical algorithm-based approach
Ambati, A., Knight, J. S., & Zuo, Y. (2023) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000932 · Cited by 65 · see citing works
“Unfortunately, it was terminated early due to the low recruitment rate and high cost [31].”
BackgroundSelf-citationPalli, E., Kravvariti, E., & Tektonidou, M. G. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00487 · Cited by 61 · see citing works
Self-citationGuidelines on the investigation and management of antiphospholipid syndrome
Arachchillage, D. J., Platton, S., Hickey, K. P., Chu, J., Pickering, M. C., Sommerville, P., MacCallum, P., & Breen, K. A. (2024) · British Journal of Haematology · doi:10.1111/bjh.19635 · Cited by 74 · see citing works
“215 However, the study was terminated early due to the low recruitment rate, lack of availability of hydroxychloroquine and substantial price increase of hydroxychloroquine in the United States.”
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
“65 Arterial thrombosis 52 (32) 87 (33) 0.”
BackgroundInfluentialSelf-citationMisra, D. P., Gasparyan, A. Y., & Zimba, O. (2020) · Rheumatology International · doi:10.1007/s00296-020-04694-2 · Cited by 60 · see citing works
“7 years of follow-up, neither group developed thrombotic events, resulting in premature termination of the trial and a subsequent inability to draw meaningful conclusions [12].”
BackgroundAn 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
“7-year follow-up period, no patients developed thrombosis or a serious adverse event [61].”
BackgroundUse of direct oral anticoagulants in antiphospholipid syndrome
Cohen, H., Efthymiou, M., & Isenberg, D. A. (2018) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.14017 · Cited by 68 · 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
“It is not clear if low-dose aspirin may or may not influence thrombotic risk,(23) 24 and the use of hydroxychloroquine for this purpose showed conflicting results.(25) 26 How to identify who to treat, and consequently how to treat, are still unanswered questions.”
BackgroundSelf-citationSafety issues and recommendations for successful pregnancy outcome in systemic lupus erythematosus
Nahal, S. K., Selmi, C. F., & Gershwin, M. E. (2018) · Journal of Autoimmunity · doi:10.1016/j.jaut.2018.07.016 · Cited by 44 · see citing works
Colafrancesco, S., Scrivo, R., Barbati, C., Conti, F., & Priori, R. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.01439 · 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
Antiphospholipid syndrome: a clinical perspective
Zuo, Y., Shi, H., Li, C., & Knight, J. S. (2020) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000705 · Cited by 36 · see citing works
“7 year follow up.([62]) Chronic HCQ usage (>5 years) at higher doses (>6.”
BackgroundSelf-citationTreatment 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
Self-citationManagement of Antiphospholipid Syndrome
Ghembaza, A., & Saadoun, D. (2020) · Biomedicines · doi:10.3390/biomedicines8110508 · Cited by 50 · 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
Zuo, Y., Barbhaiya, M., & Erkan, D. (2018) · Current Rheumatology Reports · doi:10.1007/s11926-018-0775-8 · Cited by 24 · see citing works
Self-citationChen, C., Pan, K., Wu, B., Li, X., Chen, Z., Xu, Q., Lv, Q., & Lv, Q. (2020) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-020-02962-5 · Cited by 23 · see citing works
Treatment advances in antiphospholipid syndrome: 2022 update
Erton, Z. B., & Erkan, D. (2022) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2022.102212 · Cited by 23 · see citing works
Self-citationErkan, D., Sciascia, S., Bertolaccini, M. L., Cohen, H., ANDRADE, D. C. O. D., Atsumi, T., Gerosa, M., Petri, M., Roubey, R. A. S., & Tektonidou, M. G. (2021) · Current Rheumatology Reports · doi:10.1007/s11926-021-01008-8 · Cited by 20 · see citing works
“The details of the study design, results, and challenges have been addressed elsewhere [19].”
BackgroundSelf-citationRuiz‐Irastorza, G., Tektonidou, M. G., & Khamashta, M. A. (2024) · Lara D. Veeken · doi:10.1093/rheumatology/kead538 · Cited by 20 · see citing works
Self-citationKim, J. W., Kim, T. W., Ryu, K. H., Park, S. G., Jeong, C. Y., & Park, D. H. (2020) · Journal of International Medical Research · doi:10.1177/0300060519896889 · Cited by 17 · see citing works
“Statins and hydroxychloroquine have anti-inflammatory and anti-thrombotic effects that can be considered in refractory APS as potentially reducing APS related manifestations.(43,44) Rituximab is favourable in the treatment of non-criteria APS manifestations, and several case reports have shown recovery in refractory C…”
BackgroundHisada, R., & Atsumi, T. (2023) · Biomolecules · doi:10.3390/biom13040617 · Cited by 18 · see citing works
“A randomised controlled trial, designed to prospectively evaluate the potential of HCQ in aPL carriers without systemic autoimmune disease, was prematurely terminated due to logistic reasons and low participation [76].”
BackgroundHow to diagnose and manage antiphospholipid syndrome
Hubben, A. K., & McCrae, K. R. (2023) · Hematology · doi:10.1182/hematology.2023000493 · Cited by 16 · 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
“[71] to determine the efficacy of hydroxychloroquine in the primary thrombosis prophylaxis of asymptomatic aPL carriers but was terminated early due to logistical reasons.”
BackgroundFrench National Diagnostic and Care Protocol for antiphospholipid syndrome in adults and children
Amoura, Z., Bader‐Meunier, B., Sollier, C. B. D., Bélot, A., Benhamou, Y., Bézanahary, H., Aubart, F. C., Costedoat-Chalumeau, N., Darnige, L., Drouet, L. O., et al. (2023) · La Revue de Médecine Interne · doi:10.1016/j.revmed.2023.08.004 · Cited by 13 · see citing works
Self-citationNasonov, 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
“A clinical trial of hydroxychloroquine in aPL-positive but thrombosis-free individuals without systemic autoimmune diseases enrolled 20 patients; however, there were no thrombotic events during trial follow-up in either group [77].”
BackgroundSelf-citationAlmeida-Brasil, C. C., Pineau, C. A., Vinet, É., et al. (2020) · Arthritis Care & Research · doi:10.1002/acr.24548 · Cited by 11 · see citing works
“In addition, HCQ shortages may occur in other circumstances, such as the prolonged manufacturing shortage faced by the US in 2015 (15).”
BackgroundKedia, A. K., Mohanasundaram, K., Goyal, M., et al. (2021) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.4997/jrcpe.2021.306 · Cited by 10 · see citing works
Treatment in thrombotic antiphospholipid syndrome: a review
Vadgama, T. S., Smith, A., & Bertolaccini, M. L. (2019) · Lupus · doi:10.1177/0961203319864163 · Cited by 10 · see citing works
Botelho, M. S., Bolfi, F., Leite, R. G. O. F., Leite, M. S. F., Banzato, L. R., Soares, L. T., Olivatti, T. O. F., Mangolim, A. S., Oliveira, F. R. K., Abbade, L. P. F., et al. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01835-x · Cited by 9 · 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
“These encouraging preliminary reports lead to the organization of an international consortium (APS ACTION) with the aim to set up a randomized controlled trial of HCQ in the primary thrombosis prevention of persistently aPL-positive but thrombosis free patients without other systemic autoimmune diseases(102); they had…”
Bouariu, A., Gică, N., Ciobanu, A. M., Scutelnicu, A. M., Popescu, M. R., & Panaitescu, A. M. (2022) · Healthcare · doi:10.3390/healthcare10010168 · Cited by 9 · see citing works
“, (2017) [56] Observational cohort Systemic lupus erythematosus Izmirly P.”
BackgroundNew and upcoming treatments in antiphospholipid syndrome: A comprehensive review
Signorelli, F., Balbi, G. G. M., Domingues, V., & Levy, R. A. (2018) · Pharmacological Research · doi:10.1016/j.phrs.2018.04.012 · Cited by 8 · see citing works
Risk Assessment and Antithrombotic Strategies in Antiphospholipid Antibody Carriers
Calcaterra, I. L., Ambrosino, P., Vitelli, N., Lupoli, R., Orsini, R. C., Chiurazzi, M., Maniscalco, M., & Minno, M. N. D. D. (2021) · Biomedicines · doi:10.3390/biomedicines9020122 · Cited by 8 · see citing works
“7 years, no patient developed thrombosis or a serious adverse event [72].”
BackgroundBarros Edington, F. L., de Rezende, D. F., dos Santos, L. F. S., Garcia, R. V., Gadelha, S. R., & Santiago, M. B. (2022) · Lupus · doi:10.1177/09612033221074192 · Cited by 7 · see citing works
“et al.(19) prematurely terminated in 2015 their international, multicenter, RCT that attempted to assess the efficacy of hydroxychloroquine for primary thrombosis prevention in persistently antiphospholipid (APL) Figure 4.”
BackgroundHIDROXICLOROQUINA: USO POTENCIAL EM CORONAVIROSES?
Kramer, D. G., Cavalcanti, G. B., & Pereira, N. D. S. (2020) · Revista Contexto & Saúde · doi:10.21527/2176-7114.2020.38.16-21 · Cited by 6 · see citing works
Mock Recruitment for the Study of Antimalarials in an Incomplete Lupus Erythematosus Trial
Karp, D. R., Chong, B. F., James, J. A., Arriens, C., ISHIMORI, M. L., Wallace, D. J., Liao, D., & Olsen, N. J. (2018) · Arthritis Care & Research · doi:10.1002/acr.23802 · Cited by 5 · see citing works
“Erkan and colleagues recently reported the experience of an international multicenter trial designed to explore efficacy of HCQ thrombosis prevention in patients with antiphospholipid antibody syndrome (16).”
BackgroundAbe, N., & ATSUMI, T. (2018) · Japanese Journal of Thrombosis and Hemostasis · doi:10.2491/jjsth.29.294 · Cited by 5 · see citing works
Thrombotic antiphospholipid syndrome: From guidelines to clinical management
Paredes, D., Martín‐Iglesias, D., & Ruiz‐Irastorza, G. (2024) · Medicina Clínica · doi:10.1016/j.medcli.2024.02.010 · Cited by 5 · see citing works
Natural supplements in antiphospholipid syndrome: A case for further study
Kello, N., & Cho, Y. M. (2023) · Clinical Immunology · doi:10.1016/j.clim.2023.109848 · Cited by 4 · see citing works
Hydroxychloroquine’s diverse targets: a new frontier in precision medicine
Du, B., Li, L., Li, J., Liu, Y., & Wang, P. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1655573 · 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
Hasan, M. A., Ammar, O. A.-A., Amer, M. A., Othman, A. I., Zigheber, F., & El-Missiry, M. A. (2023) · Egyptian Journal of Basic and Applied Sciences · doi:10.1080/2314808x.2023.2211832 · Cited by 2 · see citing works
“HCQ is used as prophylaxis in the primary thrombosis of patients who are positive for antiphospholipid antibody without systemic autoimmune disease [12].”
BackgroundDans-Caballero, S., Cecchi, I., Radin, M., & Sciascia, S. (2025) · Lupus · doi:10.1177/09612033251344180 · Cited by 2 · see citing works
“Despite promising results with hydroxychloroquine, 14 – 16 the evidence remains limited due to the methodology of the studies.”
Self-citationAntiphospholipid Syndrome and Cardiovascular Disease
Naseem, M., Ramesh, J., Mahmood, A., Kothari, K., Memon, F., Frishman, W. H., & Aronow, W. S. (2026) · Cardiology in Review · doi:10.1097/crd.0000000000001275 · Cited by 2 · see citing works
Management of Antiphospholipid Syndrome in Patients with Systemic Lupus Erythematosus
Yelovich, M., & Legault, K. (2019) · Current Treatment Options in Rheumatology · doi:10.1007/s40674-019-00126-w
Veselinović, M., Lucic, A. T., Jakovljevic, V. L., & Aničić, A. (2019) · Medicinski casopis · doi:10.5937/mckg53-23292
Chen, C., Pan, M., Wu, B., li, X., Chen, Z., Xu, Q., Li, X., & Lv, Q. (2020) · doi:10.22541/au.158697188.86645424
Bose, D., Konwar, M., Maurya, M. R., et al. (2021) · Current Clinical Pharmacology · doi:10.2174/1574884716666210726104424
The place of hydroxychloroquine in modern dermatology
Dańczak‐Pazdrowska, A., & Polańska, A. (2021) · Dermatology Review · doi:10.5114/dr.2021.108614
Tratamento de SAF baseado na Força Tarefa Internacional
ANDRADE, D. C. O. D., & Lopes, M. R. U. (2018) · Revista Paulista de Reumatologia · doi:10.46833/reumatologiasp.2018.17.2.28-31
Botelho, M. S., Bolfi, F., Leite, R. G. O. F., Leite, M. S. F., Banzato, L. R., Soares, L. T., Olivatti, T. O. F., Mangolim, A. S., Oliveira, F. R. K., Abbade, L. P. F., et al. (2020) · Research Square · doi:10.21203/rs.3.rs-75518/v1
Rheumatic diseases and reproductive outcomes
Mills, B. S., & Bermas, B. L. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-90805-4.00006-7
Condiciones especiales en enfermedades reumáticas
Ortiz, B. O. A. (2021) · CID - Centro de Investigación y Desarrollo eBooks · doi:10.37811/cl_w798
Hydroxychloroquine as a potential therapy for ANCA-associated vasculitis
Jain, S., Sangle, S. R., Kim, S., John, S., & D’Cruz, D. P. (2024) · Vessel Plus · doi:10.20517/2574-1209.2023.142
(2000) · Time to knit · doi:10.1016/s2211-0364(18)78958-9
Miranda, S. (2025) · EMC - Angéiologie · doi:10.1016/s2211-0364(24)48546-4
- Authors
- Erkan, D., Unlu, O., Sciascia, S., Belmont, H. M., Branch, D. W., Cuadrado, M. J., Gonzalez, E., Knight, J. S., Uthman, I., Willis, R., Zhang, Z., Wahl, D., Zuily, S., & Tektonidou, M. G.
- Affiliations
- Hospital for Special Surgery (US)
- Ospedale San Giovanni Bosco (IT)
- NYU Langone Health (US)
- University of Utah (US)
- St Thomas' Hospital (GB)
- The University of Texas Medical Branch at Galveston (US)
- University of Michigan (US)
- American University of Beirut (LB)
- Peking University First Hospital (CN)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- National and Kapodistrian University of Athens (GR)
- ORCID
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2017-08-01
- Volume
- 27
- Issue
- 3
- Pages
- 399-406
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- OpenAlex
- W2741035577
- Cited by
- 67
- References
- 33
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 9 · 2020: 14 · 2019: 8 · 2018: 14
- FWCI
- 7.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lupus (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- hydroxychloroquine, antiphospholipid antibodies, antiphospholipid syndrome, antiplatelet therapy, drug shortages, mortality
- MeSH terms
- Adult, Blood Platelets, Erythrocytes, Female, Humans, Hydroxychloroquine, Male, Middle Aged, New York
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
