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Cited by 114Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVasculitis and related conditions

Clinical study and follow-up of 100 patients withthe antiphospholipid syndrome

Muñoz-Rodríguez, Francisco J., Font, Josep, Cervera, Richard, Reverter, Joan Carles, Tàssies, Dolors, Espinosa, Gerard, López-Soto, Alfonso, Carmona, Francisco +3 more·1999·Seminars in Arthritis and Rheumatism
DOI 10.1016/s0049-0172(99)80029-8
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Abstract

Objectives To study the clinical characteristics at diagnosis and during follow-up of patients with the antiphospholipid syndrome (APS) and to analyze the influence of treatment on their outcome.Patients One hundred patients with APS were included (86% female and 14% male; mean age, 36 years). Sixty-two percent had primary APS and 38% had APS associated with systemic lupus erythematosus (SLE). The median length of follow-up was 49 months.Results Fifty-three percent of the patients had thromboses, 52% had thrombocytopenia, and 60% of the women had pregnancy losses. Patients with APS associated with SLE had a higher prevalence of hemolytic anemia (P = .02), thrombocytopenia (platelet count lower than 100 x 10(9)/L) (P = .004), antinuclear antibodies (P = .0002), and low complement levels. Fifty-three percent of the patients with thrombosis had recurrent episodes (86% in the same site as the previous thrombotic event). Recurrences were observed in 19% of the episodes treated with long-term oral anticoagulation, in 42% treated prophylactically with aspirin, and in 91% in which anticoagulant/antiaggregant treatment was discontinued (P = .0007). Multivariate analysis showed that prophylactic treatment and older age had an independent predictive value for rethrombosis. Prophylactic treatment during pregnancy (usually with aspirin) increased the live birth rate from 38% to 72% (P = .0002).Conclusions Patients with APS have a high risk of recurrent thromboses. Long-term oral anticoagulation seems to be the best prophylactic treatment to prevent recurrences. Prophylactic treatment with aspirin during pregnancy reduced the rate of miscarriages remarkably.

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  • In women with a history of fetal loss, LDA plus heparin was associated with higher likelihood of live birth than LDA alone.

    “For women with a history of fetal loss, combination treatment with LDA and heparin was associated with a higher likelihood of live birth compared with treatment with LDA alone.”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [48]

  • Data from two studies showed no difference in likelihood of live births between LDA plus heparin and LDA alone in women with prior delivery before 34 weeks due to eclampsia, severe pre-eclampsia, or placental insufficiency.

    “Data from two studies (one RCT, one retrospective cohort)48 55 showed that the likelihood of live births did not differ between women treated with LDA plus heparin and those treated with LDA alone.”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [48]

  • The studies on fetal loss included women with histories of both early and mid-pregnancy losses.

    “However, these studies included women with histories of both early and mid-pregnancy losses.48–52”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [48]

  • Pooled data from one RCT in women with first-trimester losses and eight observational studies not exclusively early losses indicated higher likelihood of live births with LDA plus prophylactic heparin versus LDA alone.

    “Pooled data from one RCT including only patients with a history of first trimester losses46 and eight supporting observational studies47–54 that did not exclusively study women with early pregnancy losses indicated a higher likelihood of live births with combination treatment with LDA and heparin at prophylactic dosage versus LDA alone.”

    From EULAR recommendations for the management of antiphospholipid syndrome in adults (2019) · cites this paper as [48]

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Authors
Muñoz-Rodríguez, F. J., Font, J., Cervera, R., Reverter, J. C., Tàssies, D., Espinosa, G., López-Soto, A., Carmona, F., Balasch, J., Ordinas, A., & Ingelmo, M.
Corresponding author
Cervera, Richard
ORCID
Venue
Seminars in Arthritis and Rheumatism
Publisher
Elsevier BV
Published
1999-12
Volume
29
Issue
3
Pages
182-190
ISSN
0049-0172 (ISSN-L)
DOI
10.1016/s0049-0172(99)80029-8
OpenAlex
W2014368662
Cited by
114
References
41
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 4
FWCI
4.73
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Seminars in Arthritis and Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
Keywords
antiphospholipid syndrome, systemic lupus erythematosus, thrombosis, recurrent thrombosis, thrombocytopenia, miscarriage, hemolytic anemia, oral anticoagulation, aspirin prophylaxis, live birth rate, antinuclear antibodies, complement levels
MeSH terms
Adolescent, Adult, Aged, Anticoagulants, Diagnosis, Differential, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Retrospective Studies, Thrombocytopenia, Thrombosis, Antiphospholipid Syndrome, Treatment Outcome, Secondary Prevention

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