TY - JOUR
TI - Characteristics of Patients With Antiphospholipid Antibody Positivity in
the APS ACTION International Clinical Database and Repository
AU - Sevim, Ecem
AU - Zisa, Diane
AU - Andrade, Danieli
AU - Sciascia, Savino
AU - and Pengo, Vittorio
AU - Tektonidou, Maria G.
AU - Ugarte, Amaia and
AU - Gerosa, Maria
AU - Belmont, H. Michael
AU - Aguirre Zamorano, Maria
AU - Angeles
AU - Fortin, Paul R.
AU - Ji, Lanlan
AU - Efthymiou, Maria and
AU - Cohen, Hannah
AU - Branch, D. Ware
AU - Jesus, Guilherme Ramires and
AU - Andreoli, Laura
AU - Petri, Michelle
AU - Rodriguez, Esther
AU - Cervera,
AU - Ricard
AU - Knight, Jason S.
AU - Atsumi, Tatsuya
AU - Willis, Rohan and
AU - Roubey, Robert
AU - Bertolaccini, Maria Laura
AU - Erkan, Doruk and
AU - Barbhaiya, Medha
AU - APS ACTION Investigators
JO - Arthritis Care and Research
PY - 2022
VL - 74
TODO - 2
SP - 324-335
PB - Wiley
SN - 2151-464X, 1529-0123
TODO - 10.1002/acr.24468
TODO - null
TODO - Objective To describe the baseline characteristics of patients with
positivity for antiphospholipid antibodies (aPLs) who were enrolled in
an international registry, the Antiphospholipid Syndrome (APS) Alliance
for Clinical Trials and International Networking (APS ACTION) clinical
database and repository, overall and by clinical and laboratory
subtypes. Methods The APS ACTION registry includes adults who
persistently had positivity for aPLs. We evaluated baseline
sociodemographic and aPL-related (APS classification criteria and
“non-criteria”) characteristics of patients overall and in subgroups
(aPL-positive without APS, APS overall, thrombotic APS only, obstetric
APS only, and both thrombotic APS/obstetric APS). We assessed baseline
characteristics of patients tested for the presence of three aPLs (lupus
anticoagulant [LAC] test, anticardiolipin antibody [aCL], and
anti-beta(2)-glycoprotein I [anti-beta(2)GPI]) antibodies by aPL
profiles (LAC only, single, double, and triple aPL positivity). Results
The 804 aPL-positive patients assessed in the present study had a mean
age of 45 +/- 13 years, were 74% female, and 68% White; additionally,
36% had other systemic autoimmune diseases. Of these 804 aPL-positive
patients, 80% were classified as having APS (with 55% having
thrombotic APS, 9% obstetric APS, and 15% thrombotic APS/obstetric
APS). In the overall cohort, 71% had vascular thrombosis, 50% with a
history of pregnancy had obstetric morbidity, and 56% had experienced
at least one non-criteria manifestation. Among those with three aPLs
tested (n = 660), 42% were triple aPL-positive. While single-, double-,
and triple aPL-positive subgroups had similar frequencies of vascular,
obstetric, and non-criteria events, these events were lowest in the
single aPL subgroup, which consisted of aCLs or anti-beta(2)GPI only.
Conclusion Our study demonstrates the heterogeneity of aPL-related
clinical manifestations and laboratory profiles in a multicenter
international cohort. Within single aPL positivity, LAC may be a major
contributor to clinical events. Future prospective analyses, using
standardized core laboratory aPL tests, will help clarify aPL risk
profiles and improve risk stratification.
ER -