Prophylaxis of Thromboses Antiphospholipid Syndrome

Chloroquine and hydroxychloroquine inhibit the aggregation of platelets. Given as thrombosis prophylaxis, hydroxychloroquine (600-800 mg/day for 1-2 weeks) reduced the rate of pulmonary emboli significantly in more than 10,000 patients with operative hip replacement (Loudon 1988). In another study, the rate of venous and arterial thromboembolic complications was significantly reduced in patients with SLE (Petri 1996). In a subgroup of SLE patients with phospholipid antibodies and a high risk of thrombotic events, thromboemboli occurred only in 4% (2/54) of the patients undergoing hydroxychloroquine therapy within 9 years, whereas in 20% of patients in the control group thromboemboli were observed within this time (Wallace et al. 1993). Therefore, chloroquine and hydroxychloroquine should be considered for the primary prophylaxis of thromboemboli in SLE. However, if thrombo-embolic complications have already occurred, anticoagulation is recommended.

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