Evidence map›Paper›PMID 27457513›Full record

GuidelineAnnals of the rheumatic diseases2017

EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome.

L Andreoli, G K Bertsias, N Agmon-Levin, S Brown, R Cervera, N Costedoat-Chalumeau, A Doria, R Fischer-Betz, F Forger, M F Moraes-Fontes and 16 more

2 registry-linked trialsOpen access · bronzeAbstract readConsensus StatementPractice GuidelineSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Annals of the rheumatic diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 338 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
338citing papers in PubMed, 19 pooled it
61.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03671174 naunknown statusnot on this mapstarted 2019, after this paper: background citation

A Three-arm, Multicenter, Open-label Randomized Controlled Trial of Hydroxychloroquine and Low-dose Prednisone on Recurrent Spontaneous Abortion With Undifferentiated Connective Tissue Diseases: Protocol for the Immunosuppressant Regimens for Living FEtuses (ILIFE) Trial

TypeinterventionalSponsorRenJi HospitalRan2019 to 2023Enrolled420ConditionsUndifferentiated Connective Tissue Disease, Recurrent Pregnancy LossArmsPrednisone, Hydroxychloroquine, Aspirin, low molecular weight heparin
NCT04354441 phase2withdrawnnot on this mapstarted 2020, after this paper: background citation

Randomized Trial Evaluating Effect of Outpatient Hydroxychloroquine on Reducing Hospital Admissions in Pregnant Women With SARS-CoV-2 Infection: HyPreC Trial

TypeinterventionalSponsorSir Mortimer B. Davis - Jewish General HospitalRan2020 to 2020Enrolled0ConditionsCOVID-19, SARS-CoV-2, Pregnant Women, HydroxychloroquineArmshydroxychloroquine sulfate 200 MG, Placebo oral tablet
3 · Its place in the literature

Who cites it

338 citing papers in PubMed, 19 syntheses or guidelines pooled it, 875 citations in OpenAlex.

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278 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 18 institutions in 14 countries.

L AndreoliDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.ORCID http://orcid.org/0000-0002-9107-3218
G K BertsiasDepartment of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, Heraklion, Greece.
N Agmon-LevinThe Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.
S BrownRoyal National Hospital For Rheumatic Diseases, Bath, UK.
R CerveraDepartment of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain.
N Costedoat-ChalumeauAP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, Paris, France.
A DoriaRheumatology Unit, Department of Medicine, University of Padua, Italy.
R Fischer-BetzPoliclinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
F ForgerDepartment of Rheumatology, Immunology and Allergology, University Hospital of Bern, Bern, Switzerland.
M F Moraes-FontesUnidade de Doenças Auto-imunes-Serviço Medicina Interna 7.2, Hospital Curry Cabral/Centro Hospitalar Lisboa Central, NEDAI/SPMI, Lisboa, Portugal.
M KhamashtaLupus Research Unit, The Rayne Institute, St. Thomas Hospital, London, UK.
J KingEULAR PARE Patient Research Partner, London, UK.
A LojaconoDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
F MarchioriEULAR PARE Patient Research Partner, Rome, Italy.
P L MeroniDepartment of Clinical Sciences and Community Health, University of Milan, Istituto Auxologico Italiano, Milan, Italy.
M MoscaRheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
M MottaNeonatology and Neonatal Intensive Care Unit, Spedali Civili, Brescia, Italy.
M OstensenNorwegian National Advisory Unit on Pregnancy and Rheumatic Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
C PamfilDepartment of Rheumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
L RaioDepartment of Obstetrics and Gynaecology, University Hospital of Bern, Inselspital, Switzerland.
M SchneiderPoliclinic of Rheumatology, Hiller Research Unit, University Clinic Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
E SvenungssonRheumatology Unit, Department of Medicine, Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
M TektonidouRheumatology Unit, Joint Academic Rheumatology Programme, 1st Department of Propaedeutic Internal Medicine Athens, National and Kapodistrian University of Athens, Athens, Greece.
S YavuzDepartment of Rheumatology, Istanbul Bilim University, Istanbul Florence Nightingale Hospital, Esentepe-Istanbul, Turkey.
D Boumpas4th Department of Internal Medicine, 'Attikon' University Hospital, Medical School, University of Athens, Athens, Greece.
A TincaniDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia · ITDüsseldorf University Hospital · DENational and Kapodistrian University of Athens · GRUniversity Hospital of Bern · CHDélégation Paris 5 · FRHospital Clínic de Barcelona · ESHospital Curry Cabral · PTIstanbul Bilim University · TRIuliu Hațieganu University of Medicine and Pharmacy · ROKarolinska University Hospital · SERoyal National Hospital for Rheumatic Diseases · GBSt Olav's University Hospital · NOSt Thomas' Hospital · GBTel Aviv University · ILUniversity of Crete · GRUniversity of Milan · ITUniversity of Padua · ITUniversity of Pisa · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDevelop recommendations for women's health issues and family planning in systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS).

methodsSystematic review of evidence followed by modified Delphi method to compile questions, elicit expert opinions and reach consensus.

resultsFamily planning should be discussed as early as possible after diagnosis. Most women can have successful pregnancies and measures can be taken to reduce the risks of adverse maternal or fetal outcomes. Risk stratification includes disease activity, autoantibody profile, previous vascular and pregnancy morbidity, hypertension and the use of drugs (emphasis on benefits from hydroxychloroquine and antiplatelets/anticoagulants). Hormonal contraception and menopause replacement therapy can be used in patients with stable/inactive disease and low risk of thrombosis. Fertility preservation with gonadotropin-releasing hormone analogues should be considered prior to the use of alkylating agents. Assisted reproduction techniques can be safely used in patients with stable/inactive disease; patients with positive antiphospholipid antibodies/APS should receive anticoagulation and/or low-dose aspirin. Assessment of disease activity, renal function and serological markers is important for diagnosing disease flares and monitoring for obstetrical adverse outcomes. Fetal monitoring includes Doppler ultrasonography and fetal biometry, particularly in the third trimester, to screen for placental insufficiency and small for gestational age fetuses. Screening for gynaecological malignancies is similar to the general population, with increased vigilance for cervical premalignant lesions if exposed to immunosuppressive drugs. Human papillomavirus immunisation can be used in women with stable/inactive disease.

conclusionsRecommendations for women's health issues in SLE and/or APS were developed using an evidence-based approach followed by expert consensus.

Indexed as

Antiphospholipid SyndromeContraceptives, Oral, HormonalDelphi TechniqueEarly Detection of CancerEstrogen Replacement TherapyFamily Planning ServicesFemaleFertility PreservationFetal MonitoringGenital Neoplasms, FemaleHumansLupus Erythematosus, SystemicMenopausePreconception CarePregnancyPregnancy ComplicationsContraceptives, Oral, HormonalAntiphospholipid AntibodiesAntiphospholipid SyndromeMultidisciplinary team-careSystemic Lupus ErythematosusUltrasonography

Identifiers

PMID27457513
PMCPMC5446003
OpenAlexW2278093194

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.