Hydroxychloroquine initiation among pregnant women with systemic lupus erythematosus (SLE) increased from 2001 to 2015, but its use “remains low, and that is concerning for maternal and fetal well-being,” said investigators who analyzed one public and one private database.

The two databases showed increases of somewhat different scale. According to Medicaid data on 3,045 pregnancies among SLE women, initiation of hydroxychloroquine rose from 2.7% in 2001 to 7.5% (P = .0002) in 2010. The analysis of data for 2,255 SLE pregnancies from a large commercial insurance database (Optum Clinformatics) showed an increase from 4.9% in 2003 to 13.6% (P = .0001) in 2015, wrote Bonnie L. Bermas, MD, of Brigham and Women’s Hospital, Boston, and her associates. The report was published in Lupus .

The proportion of women with SLE who were taking hydroxychloroquine before pregnancy and continued it during pregnancy increased in both databases but not significantly: from 67% in 2001 to 72% in 2010 (P = .70) for Medicaid and from 75% in 2004 to 87% in 2015 (P = .07) for Clinformatics. Overall, the proportion of women in both databases who filled hydroxychloroquine prescriptions in pregnancy was 17.2% for the entire study period: The change was 12.4% from 2001 to 37.7% in 2015, the investigators said.

The study was funded by Brigham and Women’s Hospital and Harvard Medical School. Dr. Bermas did not report any conflicts. Her associates reported unrelated projects with a number of pharmaceutical companies.

SOURCE: Bermas BL et al. Lupus. 2018 Jan 4. doi: 10.1177/0961203317749046 .