Heghine Khachatryan։ Targeting High Risk Antiphospholipid Syndrome in Pregnancy with Hydroxychloroquine
Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared a post on Linkedin:
”Antiphospholipid Syndrome in Pregnancy: Is There a Role for Hydroxychloroquine?
In recent years, the management of obstetric antiphospholipid syndrome (APS) has evolved beyond conventional therapy.
While low-dose aspirin and LMWH remain the cornerstone, an important question emerges:
What should we do in refractory or high-risk APS?
Emerging evidence suggests:
Hydroxychloroquine (Plaquenil) exerts:
- Anti-thrombotic effects
- Modulation of aPL-mediated endothelial injury
- Reduction of placental inflammation and microthrombosis
Clinical data indicate:
- Improved live birth rates
- Reduced pregnancy complications
– particularly in refractory APS
Who may benefit most?
- Triple-positive APS
- Refractory obstetric APS
- APS associated with SLE
Clinical positioning:
Hydroxychloroquine is not first-line, but:
- A valuable adjunctive therapy
- Considered in high-risk or treatment-resistant cases
Safety profile:
- Well-established safety in pregnancy
- No proven teratogenicity
- Long-standing use in autoimmune diseases
Key message:
APS in pregnancy is not a uniform entity — it is a risk spectrum requiring precision medicine.
Hydroxychloroquine represents a strategic addition, not for all, but for those who need more than standard therapy.”
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