{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:44:30Z","timestamp":1790361870772,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The effect of additional treatments combined with conventional therapy on pregnancy outcomes was examined in high-risk primary antiphospholipid syndrome (PAPS) patients to identify the most effective treatment strategy. The study's inclusion criteria were (1) positivity to lupus anticoagulant alone or associated with anticardiolipin and\/or anti-\u03b22 glycoprotein I antibodies; (2) a history of severe maternal\u2013foetal complications (Group I) or a history of one or more pregnancies refractory to conventional therapy leading to unexplained foetal deaths not associated with severe maternal\u2013foetal complications (Group II). Two different additional treatments were considered: oral\u2014low-dose steroids (10\u201320\u2009mg prednisone daily) and\/or 200 to 400\u2009mg daily doses of hydroxychloroquine and parenteral\u2014intravenous immunoglobulins at 2 g\/kg per month and\/or plasma exchange. The study's primary outcomes were live birth rates and pregnancy complications. A total of 194 pregnant PAPS patients attending 20 tertiary centres were retrospectively enrolled. Hydroxychloroquine was found to be linked to a significantly higher live birth rate with respect to the other oral treatments in the Group II patients. The high (400 mg) versus low (200 mg) doses of hydroxychloroquine (p\u2009=\u20090.036) and its administration before versus during pregnancy (p\u2009=\u20090.021) were associated with a significantly higher live birth rate. Hydroxychloroquine therapy appeared particularly efficacious in the PAPS patients without previous thrombosis. Parenteral treatments were associated with a significantly higher live birth rate with respect to the oral ones (p\u2009=\u20090.037), particularly in the Group I patients. In conclusion, some additional treatments were found to be safe and efficacious in high-risk PAPS pregnant women.<\/jats:p>","DOI":"10.1055\/s-0038-1632388","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T18:48:36Z","timestamp":1519843716000},"page":"639-646","source":"Crossref","is-referenced-by-count":23,"title":["Effect of Additional Treatments Combined with Conventional Therapies in Pregnant Patients with High-Risk Antiphospholipid Syndrome: A Multicentre Study"],"prefix":"10.1055","volume":"47","author":[{"given":"Marta","family":"Tonello","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariela","family":"Hoxha","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Sciascia","sequence":"first","affiliation":[{"name":"Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Cuadrado","sequence":"first","affiliation":[{"name":"Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Latino","sequence":"first","affiliation":[{"name":"Autoimmune,Thrombophilic Diseases and Pregnancy Division, Dr. Carlos G Durand Hospital, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Udry","sequence":"first","affiliation":[{"name":"Autoimmune,Thrombophilic Diseases and Pregnancy Division, Dr. Carlos G Durand Hospital, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Reshetnyak","sequence":"first","affiliation":[{"name":"Department of Systemic Rheumatic Disease, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Costedoat-Chalumeau","sequence":"first","affiliation":[{"name":"AP-HP, Cochin Hospital, Internal Medicine Department, Centre de R\u00e9f\u00e9rence Maladies Auto-immunes et Syst\u00e9miques Rares, Paris, France"},{"name":"Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"},{"name":"INSERM U 1153, Centre for Epidemiology and Statistics, Sorbonne Paris Cit\u00e9 (CRESS), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Morel","sequence":"first","affiliation":[{"name":"AP-HP, Cochin Hospital, Internal Medicine Department, Centre de R\u00e9f\u00e9rence Maladies Auto-immunes et Syst\u00e9miques Rares, Paris, France"},{"name":"Universit\u00e9 Paris Descartes, Sorbonne Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Marozio","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Universit\u00e0 di Torino, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Tincani","sequence":"first","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Andreoli","sequence":"first","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Haladyj","sequence":"first","affiliation":[{"name":"Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier","family":"Meroni","sequence":"first","affiliation":[{"name":"Division of Rheumatology, G. Pini Institute, Milan"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"},{"name":"Istituto Auxologico IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gerosa","sequence":"first","affiliation":[{"name":"Division of Rheumatology, G. Pini Institute, Milan"},{"name":"Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy"},{"name":"Istituto Auxologico IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Alijotas-Reig","sequence":"first","affiliation":[{"name":"Systemic Autoimmune Diseases Unit, Department of Medicine, Vall d'Hebron University Hospital, Barcelona, Spain"},{"name":"Department of Medicine, Faculty of Medicine, Universitat Aut\u00f2noma, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Tenti","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Neuroscience, Rheumatology Unit, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karoline","family":"Mayer-Pickel","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Medical University Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Simchen","sequence":"first","affiliation":[{"name":"Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sheba Medical Centre, Tel Hashomer, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bertero","sequence":"first","affiliation":[{"name":"Clinical Immunology, AO Ordine Mauriziano, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"De Carolis","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00e9ronique","family":"Ramoni","sequence":"first","affiliation":[{"name":"Division of Rheumatology, IRCCS Policlinico S. Matteo, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ars\u00e8ne","family":"Mekinian","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne et l'inflammation-(DHU i2B), H\u00f4pital Saint-Antoine, Universit\u00e9 Paris 06, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Grandone","sequence":"first","affiliation":[{"name":"Atherosclerosis and Thrombosis Unit, I.R.C.C.S. Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Maina","sequence":"first","affiliation":[{"name":"Servizio di Medicina Interna, Ospedale Sant'Anna, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1tima","family":"Serrano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar de Lisboa Central, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Pengo","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy"},{"name":"Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munther","family":"Khamashta","sequence":"first","affiliation":[{"name":"Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, United Kingdom"},{"name":"Lupus Research Unit, The Rayne Institute, Division of Women's Health, St Thomas Hospital, London, United Kingdom"},{"name":"Department of Rheumatology, Dubai Hospital, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Ruffatti","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,2,28]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1632388.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T15:19:35Z","timestamp":1540394375000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1632388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,28]]},"references-count":0,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2018,4,4]]},"published-print":{"date-parts":[[2018,7]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1632388","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,28]]}}}