Hydroxychloroquine (Indication Antiphospholipid Syndrom)

Intrauterine deaths (as a whole or unspecified)

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S13690
R53231		 Elsenity, 2022 Fetal loss throughout pregnancy randomized controlled trial unexposed, sick Adjustment: Randomisation Co-administration Indication HCQ: Antiphospholipid syndrome (APS) 0.38 [0.17;0.84] C 17/50   30/52 47 50
ref
S13685
R53188		 Gerde, 2021 Pregnancy losses throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Co-administration Indication HCQ: Antiphospholipid syndrome (APS) 0.05 [0.01;0.24] C 2/69   12/32 14 69
ref
S13717
R53436		 Ruffatti, 2018 Non live birth during pregnancy (anytime or not specified) retrospective cohort exposed to other treatment, sick Adjustment: No Indication HCQ: Antiphospholipid syndrome (APS) 0.44 [0.17;1.16] C 12/94   9/36 21 94
ref
S13674
R53131		 Ye, 2017 Repeat pregnancy loss throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Co-administration Indication HCQ: Antiphospholipid syndrome (APS) 0.43 [0.22;0.84] C 14/126   32/141 46 126
ref
S13712
R53406		 Mekinian, 2016 Pregnancy losses (NOS) during pregnancy (anytime or not specified) prospective cohort unexposed, sick Adjustment: No Indication HCQ: Antiphospholipid syndrome (APS) 0.13 [0.03;0.59] 2/12   279/462 281 12
ref
S13718
R53439		 Sciascia, 2016 Intrauterine deaths throughout pregnancy retrospective cohort unexposed, sick Adjustment: No Indication HCQ: Antiphospholipid syndrome (APS) 0.51 [0.26;1.01] C 17/51   59/119 76 51
ref
S13711
R53403		 Mekinian, 2015 Pregnancy losses during pregnancy (anytime or not specified) retrospective cohort unexposed, sick Adjustment: No Indication HCQ: Antiphospholipid syndrome (APS) 2.38 [0.44;12.91] C 6/35   2/25 8 35
ref
Total 7 studies 0.37 [0.21;0.65] 493 437
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Elsenity, 2022Elsenity, 2022 0.38[0.17; 0.84]475018%ROB confusion: lowROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: low Gerde, 2021Gerde, 2021 0.05[0.01; 0.24]14699%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: lowROB mesure: criticalROB reporting: moderate Ruffatti, 2018Ruffatti, 2018 0.44[0.17; 1.16]219415%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: moderate Ye, 2017Ye, 2017 0.43[0.22; 0.84]4612620%ROB confusion: seriousROB selection: unclearROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Mekinian, 2016Mekinian, 2016 0.13[0.03; 0.59]2811210%ROB confusion: criticalROB selection: unclearROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Sciascia, 2016Sciascia, 2016 0.51[0.26; 1.01]765120%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Mekinian, 2015Mekinian, 2015 2.38[0.44; 12.91]8358%ROB confusion: criticalROB selection: unclearROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Total (7 studies) I2 = 56% 0.37[0.21; 0.65]4934370.05.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.36[0.18; 0.73]44638764%NAGerde, 2021 Ruffatti, 2018 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 6 case control studiescase control studies 0 RCTRCT 0.38[0.17; 0.84]4750 -NAElsenity, 2022 1 Type of controls unexposed, sickunexposed, sick 0.35[0.18; 0.70]47234363%NAElsenity, 2022 Gerde, 2021 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 6 exposed to other treatment, sickexposed to other treatment, sick 0.44[0.17; 1.16]2194 -NARuffatti, 2018 1 Tags Adjustment   - No  - No 0.36[0.18; 0.73]44638764%NAGerde, 2021 Ruffatti, 2018 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 6   - Randomisation  - Randomisation 0.38[0.17; 0.84]4750 -NAElsenity, 2022 1 Co-administrationCo-administration 0.26[0.10; 0.67]10724568%NAElsenity, 2022 Gerde, 2021 Ye, 2017 3 Indication HCQ   - Antiphospholipid syndrome (APS)  - Antiphospholipid syndrome (APS) 0.37[0.21; 0.65]49343756%NAElsenity, 2022 Gerde, 2021 Ruffatti, 2018 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 7 All studiesAll studies 0.37[0.21; 0.65]49343756%NAElsenity, 2022 Gerde, 2021 Ruffatti, 2018 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 70.05.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.63.61.0360.000Elsenity, 2022Gerde, 2021Ruffatti, 2018Ye, 2017Mekinian, 2016Sciascia, 2016Mekinian, 2015

Asymetry test p-value = 0.5139 (by Egger's regression)

slope=-0.3616 (0.8494); intercept=-1.2584 (1.7921); t=0.7022; p=0.5139

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls Out of scale0.35[0.18; 0.70]47234363%NAElsenity, 2022 Gerde, 2021 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 6 exposed to other treatment, sick controlsexposed to other treatment, sick controls Out of scale0.44[0.17; 1.16]2194 -NARuffatti, 2018 10.510.01.0

Umbrella review (other published meta-analyses)

Published MATE95% CIn exposedkI2Control groupExposition period Clowse (Antiphospholipid syndrome)Clowse (Antiphospholipid syndrome) Out of scale0.46[0.10; 2.06]NA-whatever (meta-analysis)during pregnancy (anytime or not specified)studies-9 metaPregmetaPreg Out of scale0.37[0.21; 0.65]56%437--Elsenity, 2022 Gerde, 2021 Ruffatti, 2018 Ye, 2017 Mekinian, 2016 Sciascia, 2016 Mekinian, 2015 70.510.01.0