HYDROXYCHLOROQUINE IS A POTENTIAL THERAPEUTIC OPTION FOR PREECLAMPSIA PREVENTION AMONG PREGNANT WOMEN WITH PREVIOUS PREECLAMPSIA: A PILOT RANDOMIZED CONTROLLED TRIAL

Abstract

Abstract

Objectives

Abnormal immune response towards the fetus, impaired early placentation, and maternal endothelial dysfunction are possible pathogenesis of preeclampsia. The study aim was to investigate the role of Hydroxychloroquine (HCQ) in preeclampsia prevention among pregnant women with previous history of preeclampsia.

Methods

This was a pilot open label randomized controlled trial, prospectively registered on Clinical Trials (NCT04755322). This study conducted at the Women's Health Hospital, Assiut University, Egypt, from March 1, 2021, to July 30, 2023. Participants were randomized to receive either Group I (n=25) received 200 mg of oral HCQ twice daily, alongside low dose aspirin or Group II (n=25) received low dose aspirin alone. Both interventions were started in the first 6 weeks of gestation and continued till 36 weeks of gestation.

Results

The baseline characteristics were homogenous between both study groups. The study showed that preeclampsia rate was (12%) in HCQ group versus (20%) in the control group but the difference was not statistical significant (p=0.702). There was no significant differences between both groups regarding neonatal outcomes and preeclampsia associated complications. The side effects of the therapy were minimal and no serious adverse effects was reported.

Conclusion

HCQ may be beneficial treatment for prevention of preeclampsia but we needed a properly designed studies to prove its efficacy. Also, HCQ could be considered as an adjunctive therapy to low-dose aspirin for PE prevention in high-risk women. In women with prior preeclampsia, there was no benefit of HCQ regarding fetal growth restriction, preterm birth, neonatal outcomes and preeclampsia associated complications. HCQ appears to be safe to the fetus with few maternal side effects.