Treatment for patients with recurrent fetal losses positive for anti-cardiolipin beta2 glycoprotein I antibody using Sairei-to (Chai-ling-tang) and low-dose aspirin

J Obstet Gynaecol Res. 2019 Mar;45(3):549-555. doi: 10.1111/jog.13871. Epub 2018 Dec 4.

Abstract

Aim: Recently, it is widely recognized that positivity for anti-phospholipid antibodies is a causative factor for a range of reproductive failures. Anti-cardiolipin beta2 glycoprotein I antibody (anti-CL-beta2-GPI) is a representative anti-phospholipid antibody, which strongly correlates with the development of thrombotic events and diversity of adverse pregnancies. In this series, we aimed to elucidate effective treatment for patients with recurrent fetal losses positive for anti-CL-beta2-GPI using Japanese-modified Chinese herbal medicine.

Methods: Twenty-one patients with recurrent fetal losses who were positive for anti-CL-beta2-GPI were treated with the Japanese-modified Chinese herbal medicine, Sairei-to (Chai-ling-tang), and low-dose aspirin with or without adrenal corticosteroid hormone. Of the 21 patients, the value of anti-CL-beta2-GPI ranged from 1.9 to 3.4 in 10 patients, and it was over 3.5 in 11 patients.

Results: Of the 21 patients treated with the current protocol, the pregnancy successfully continued in 17 patients (success rate: 81.0%). Of the four patients who showed repeated abortion, chromosome abnormality of chorionic villi was observed in two; thus, the success rate would be 89.5% (17 of 19 cases) on excluding these cases from the evaluation.

Conclusion: The efficacy of the current treatment adopting the modified Japanese version of the Chinese herbal medicine Sairei-to for patients with recurrent fetal losses positive for anti-CL-beta2-GPI was indicated.

Keywords: Japanese-modified Chinese herbal medicine; Sairei-to (Chai-ling-tang); anti-cardiolipin beta2 glycoprotein I; anti-phospholipid antibody; low-dose aspirin; reproductive failure.

MeSH terms

  • Abortion, Habitual / drug therapy*
  • Abortion, Habitual / immunology
  • Adult
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use*
  • Autoantibodies / immunology
  • Cardiolipins / immunology*
  • Drug Therapy, Combination
  • Drugs, Chinese Herbal / administration & dosage
  • Drugs, Chinese Herbal / therapeutic use*
  • Female
  • Humans
  • Pregnancy
  • Treatment Outcome
  • beta 2-Glycoprotein I / immunology*

Substances

  • Autoantibodies
  • Cardiolipins
  • Drugs, Chinese Herbal
  • beta 2-Glycoprotein I
  • sairei-to
  • Aspirin