Efficacy And Safety Of Hydroxychloroquine In The Treatment Of Pregnant Patient With Lupus Erythematosus:a Meta Analysis

Objective: To systematically evaluate the efficacy and safety of hydroxychloroquine in the treatment of pregnant patient with Lupus Erythematosus.Methods: Databases of Cochrane library, Medline, EMBase,Pub Med,CNKI, Chinese biomedical literature database(CBM), VIP,Wanfang digital journals were searched for randomized controlled trials(RCTs) or comparative study of hydroxychloroquine in the treatment of pregnant patient with Lupus Erythematosus. The Rev Man 5.1 statistical software was employed to conduct systematic review.Results: We included 6 pieces of literature and 278 patients. Meta analysis results suggested that the experimental group had lower lupus activity rate(OR=0.24, 95%CI=0.11 ~ 0.54, P=0.0005) and had lower systemic lupus erythematosus disease activity index(SLEDAI) in the mid and late pregnancy(MD=-2.24,95%CI=-3.26~1.22,P=0.000;MD=-2.59,95%CI=-3.70~1.48,P=0.000);The two groups were not significantly different in the early pregnancy in SLEDAI(MD=-0.14,95%CI=-1.07~0.79,P=0.77);The two groups were significantly different in the incidence rate of adverse pregnancy outcomes(OR=0.41,95%CI=0.22~0.75,P=0.004);The experimental group of fetal body quality is higher than the control group(MD=314.64,95%CI=137.88~491.40,P=0.0005);There was no significant differences in neonatal 1 minute Apgar score(MD=0.23,95%CI=-0.12~0.58,P=0.21)and neonatal 5 minute Apgar score(MD=0.14,95%CI=-0.14~0.41,P=0.32).Conclusions: HCQ can decrease the rates of lupus activity and the risk of adverse pregnancy outcomes,moreover,the experimental group had lower SLEDAI in the mid and late pregnancy in pregnant patient with lupus erythematosus,without increasing the risk of adverse fetal outcomes.