{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:11:28Z","timestamp":1790187088025,"version":"4.1.0"},"reference-count":61,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MRC UK","award":["MR\/V037633\/1"],"award-info":[{"award-number":["MR\/V037633\/1"]}]},{"name":"MRC UK","award":["21223"],"award-info":[{"award-number":["21223"]}]},{"name":"Versus Arthritis","award":["MR\/V037633\/1"],"award-info":[{"award-number":["MR\/V037633\/1"]}]},{"name":"Versus Arthritis","award":["21223"],"award-info":[{"award-number":["21223"]}]},{"name":"Imperial College-Wellcome Trust Institutional Strategic","award":["MR\/V037633\/1"],"award-info":[{"award-number":["MR\/V037633\/1"]}]},{"name":"Imperial College-Wellcome Trust Institutional Strategic","award":["21223"],"award-info":[{"award-number":["21223"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Antiphospholipid syndrome (APS) is an acquired highly prothrombotic disorder in which thrombo-inflammatory antiphospholipid antibodies (aPL) cause thrombosis via multiple mechanisms, including endothelial damage and activation. Obstetric complications in APS are caused by placental thrombosis, inflammation and complement activation. Anticoagulation is poorly effective in some patients especially those with triple positive aPL who are at ~30% risk of thrombosis recurrence within 10 years. Increasing therapeutic anticoagulation intensity may be beneficial but leads to excess bleeding with serious complications, such as intracerebral haemorrhage. Nonetheless, anticoagulation is still the mainstay of treatment despite the autoimmune nature of APS. The antimalarial immunomodulatory drug hydroxychloroquine (HCQ) has been used for many years for the treatment of inflammatory rheumatic diseases. HCQ has complex pleiotropic mechanisms of action upon multiple cell types. The proposed biological processes that HCQ regulates support the hypothesis that it may be a successful adjunctive treatment in the prevention of recurrent thrombosis and pregnancy complications.<\/jats:p>","DOI":"10.3390\/ijms24021331","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T01:33:12Z","timestamp":1673400792000},"page":"1331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Hydroxychloroquine as an Immunomodulatory and Antithrombotic Treatment in Antiphospholipid Syndrome"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5993-4850","authenticated-orcid":false,"given":"Deepa J.","family":"Arachchillage","sequence":"first","affiliation":[{"name":"Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London W12 0NN, UK"},{"name":"Department of Haematology, Imperial College Healthcare NHS Trust, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Laffan","sequence":"additional","affiliation":[{"name":"Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London W12 0NN, UK"},{"name":"Department of Haematology, Imperial College Healthcare NHS Trust, London W12 0HS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charis","family":"Pericleous","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London W12 0NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/bjh.14632","article-title":"Pathogenesis and management of antiphospholipid syndrome","volume":"178","author":"Arachchillage","year":"2017","journal-title":"Br. 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