Hydroxychloroquine as a Preventive and Therapeutic Option in Preeclampsia – a Literature Review

Abstract

Preeclampsia is one of the most feared complications of pregnancy and puerperium and represents a serious threat to mother and child. In addition, a history of preeclampsia increases the risk of future cardiovascular events. New diagnostic and therapeutic approaches are needed. New therapeutic options are currently being discussed, one of which is the administration of hydroxychloroquine. It is an antimalarial drug which is also used to treat rheumatological disease and its use in pregnancy is considered safe. A reduced incidence of preeclampsia in patients with selected rheumatological disorders after administration of hydroxychloroquine has already been shown; however, the case numbers are very low. Neither the full pathogenesis of preeclampsia nor the exact modes of action of hydroxychloroquine have been completely elucidated, but there are several common features which make hydroxychloroquine a promising option for the prevention and treatment of preeclampsia. Further research, especially prospective, randomized controlled trials, is needed to prove its efficacy. This review discusses the pathogenesis of preeclampsia and gives an overview of new options for its prevention and treatment, including the administration of hydroxychloroquine in pregnancy.

Zusammenfassung

Die Präeklampsie zählt zu den am meisten gefürchteten Schwangerschafts- und Wochenbettkomplikationen und stellt eine ernste Gefahr für Mutter und Kind dar. Hinzu kommt noch, dass eine vorherige Präeklampsie das Risiko für künftige kardiovaskuläre Ereignisse erhöht. Neue diagnostische und therapeutische Konzepte werden benötigt. Einige neue therapeutische Optionen werden inzwischen diskutiert, darunter die Gabe von Hydroxychloroquin. Hydroxychloroquin ist ein Antimalariamittel, das auch zur Behandlung von rheumatologischen Erkrankungen eingesetzt wird, und der Einsatz dieses Medikaments während der Schwangerschaft gilt als sicher. Bei Patientinnen mit spezifischen rheumatologischen Erkrankungen, die mit Hydroxychloroquin behandelt wurden, reduzierte sich die Häufigkeit von Präeklampsie, aber die Fallzahlen waren sehr niedrig. Weder die komplette Pathogenese von Präeklampsie noch die präzise Wirkungsweise von Hydroxychloroquin sind bislang gänzlich geklärt, aber es gibt mehrere Gemeinsamkeiten, die darauf hindeuten, dass Hydroxychloroquin eine vielsprechende Möglichkeit zur Prävention und Behandlung von Präeklampsie darstellen könnte. Es werden weitere Untersuchungen, insbesondere prospektive, randomisierte kontrollierte Studien, benötigt, um die Wirksamkeit von Hydroxychloroquin zu belegen. In dieser Übersichtsarbeit wird die Pathogenese von Präeklampsie diskutiert, und es wird ein Überblick der neuesten Optionen bei der Prävention und Behandlung von Präeklampsie einschließlich der Hydroxychloroquin-Gabe während der Schwangerschaft vermittelt.

Key words

hydroxychloroquine - rheumatological disease - preeclampsia

Schlüsselwörter

Hydroxychloroquin - rheumatologische Erkrankungen - Präeklampsie

Publikationsverlauf

Eingereicht: 12. Februar 2020

Angenommen nach Revision: 03. Mai 2020

Artikel online veröffentlicht:
14. Juli 2020

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