@article{3166148,
    title = "Morbidity and mortality in the antiphospholipid syndrome during a
10-year period: a multicentre prospective study of 1000 patients",
    author = "Cervera, R. and Serrano, R. and Pons-Estel, G. J. and Ceberio-Hualde, L. and and Shoenfeld, Y. and de Ramon, E. and Buonaiuto, V. and Jacobsen, S. and and Zeher, M. M. and Tarr, T. and Tincani, A. and Taglietti, M. and and Theodossiades, G. and Nomikou, E. and Galeazzi, M. and Bellisai, F. and and Meroni, P. L. and Derksen, R. H. W. M. and de Groot, P. G. D. and and Baleva, M. and Mosca, M. and Bombardieri, S. and Houssiau, F. and Gris, and J-C and Quere, I. and Hachulla, E. and Vasconcelos, C. and and Fernandez-Nebro, A. and Haro, M. and Amoura, Z. and Miyara, M. and and Tektonidou, M. and Espinosa, G. and Bertolaccini, M. L. and Khamashta, and M. A. and Euro-Phospholipid Project Grp",
    journal = "Annals of the Rheumatic Diseases",
    year = "2015",
    volume = "74",
    number = "6",
    pages = "1011-1018",
    publisher = "BMJ Publishing Group",
    issn = "0003-4967, 1468-2060",
    doi = "10.1136/annrheumdis-2013-204838",
    keywords = "Anticardiolipin Antibodies; Antiphospholipid Antibodies;
Antiphospholipid Syndrome; Autoimmune Diseases; Systemic Lupus
Erythematosus",
    abstract = "Objectives To assess the prevalence of the main causes of
morbi-mortality in the antiphospholipid syndrome (APS) during a
10-year-follow-up period and to compare the frequency of early
manifestations with those that appeared later.
Methods In 1999, we started an observational study of 1000 APS patients
from 13 European countries. All had medical histories documented when
entered into the study and were followed prospectively during the
ensuing 10years.
Results 53.1% of the patients had primary APS, 36.2% had APS
associated with systemic lupus erythematosus and 10.7% APS associated
with other diseases. Thrombotic events appeared in 166 (16.6%) patients
during the first 5-year period and in 115 (14.4%) during the second
5-year period. The most common events were strokes, transient ischaemic
attacks, deep vein thromboses and pulmonary embolism. 127 (15.5%) women
became pregnant (188 pregnancies) and 72.9% of pregnancies succeeded in
having one or more live births. The most common obstetric complication
was early pregnancy loss (16.5% of the pregnancies). Intrauterine
growth restriction (26.3% of the total live births) and prematurity
(48.2%) were the most frequent fetal morbidities. 93 (9.3%) patients
died and the most frequent causes of death were severe thrombosis
(36.5%) and infections (26.9%). Nine (0.9%) cases of catastrophic APS
occurred and 5 (55.6%) of them died. The survival probability at
10years was 90.7%.
Conclusions Patients with APS still develop significant morbidity and
mortality despite current treatment. It is imperative to increase the
efforts in determining optimal prognostic markers and therapeutic
measures to prevent these complications."
}