GAPSS: the Global Anti-Phospholipid Syndrome Score
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OBJECTIVE: To develop and validate a risk score [global APS score (GAPSS)] derived from the combination of independent risk for thrombosis and pregnancy loss (PL), taking into account the aPL profile, conventional cardiovascular risk factors and the autoimmune antibody profile. METHODS: This cross-sectional study included 211 consecutive SLE patients. Data on clinical manifestations, conventional cardiovascular risk factors, aPL profile, ANAs, ENA and anti-dsDNA were collected. Long-term low-dose aspirin, oral anticoagulant and HCQ treatment were also included in the analysis. Patients were randomly divided into two sets by a computer-generated randomized list. We developed GAPSS in the first set of patients (n = 106), assigning the risk factors identified by multivariate analysis weighted points proportional to the β-regression coefficient values. GAPSS was validated in the second set of patients (n = 105). The relationship between GAPPS and thrombosis and/or PL was analysed. RESULTS: In the first set, higher values of GAPSS were seen in patients who experienced thrombosis and/or PL compared with those without clinical events [GAPSS 9.3 (4.8) (range 1-19) and 5.3 (4) (range 0-16), P < 0.001]. Also taken separately, patients who experienced thrombosis or PL showed higher GAPSS compared with those without clinical events [GAPSS 9.6 (4.8) (range 1-19) vs 4.9 (5) (range 0-14), P = 0.027 for thrombosis; 7.3 (5) vs 3.9 (5.1) (range 0-16), P = 0.024 for PL, respectively]. In the second set, the results were similar, with statistically higher values of GAPSS in patients with a clinical history of thrombosis and/or PL compared with those without events [GAPSS 9.5 (5.6) (range 0-20) and 3.9 (4.1) (range 0-17), P < 0.001). Higher values were also seen when subclassifying the patients according to the clinical manifestation, thrombosis or PL [GAPSS 9.5 (5.6) (range 0-20) vs 4.8 (5.4) (range 0-17), P = 0.036 for thrombosis; 7.9 (3.3) vs 3.8 (5.4) (range 0-16), P = 0.037 for PL, respectively). CONCLUSION: These data propose a substantial improvement in risk prediction of thrombosis or PL in SLE based on assessment of the GAPSS, a quantitative scoring system.
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The results are not directly generalizable to other patient groups included in the wide and heterogenic spectrum of APS, such as patients with SLE or patients who are positive for aCL or aβ2-GPI but not LA.
“Consequently, our results are not directly generalizable to other patient groups included in the wide and heterogenic spectrum of APS, such as patients with SLE [34, 38] or patients who are positive for aCL or aβ2-GPI but not LA [39].”
From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [34]
The citation [39] is attached to the example of patients positive for aCL or anti-β2GPI but not LA, rather than to the citing authors’ conclusion about generalizability. The Patients section lists all three as separately measured antibodies, and the results treat them as separate risk factors. Our copy does not specifically identify or analyze patients positive for aCL or anti-β2GPI while negative for LA. (LLM, conf=0.78)
Experimental — accuracy not yet measuredA risk score for anamnestic thrombotic risk in patients with SLE, the Global Anti-Phospholipid Syndrome Score (GAPSS), includes two general cardiovascular risk factors: hypertension and hyperlipidemia.
“Further, a risk score for anamnestic thrombotic risk in patients with SLE, the Global Anti-Phospholipid Syndrome Score (GAPSS), includes two general cardiovascular risk factors: hypertension and hyperlipidemia [34].”
From Cardiovascular risk factors are major determinants of thrombotic risk in patients with the lupus anticoagulant (2017) · cites this paper as [34]
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- Authors
- Sciascia, S., Sanna, G., Murru, V., Roccatello, D., Khamashta, M. A., & Bertolaccini, M. L.
- Affiliations
- King's College London (GB)
- St Thomas' Hospital (GB)
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-12
- Volume
- 52
- Issue
- 8
- Pages
- 1397-1403
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- OpenAlex
- W2127565509
- Cited by
- 318
- References
- 28
- Citations by year
- 2026: 23 · 2025: 22 · 2024: 21 · 2023: 26 · 2022: 32 · 2021: 26 · 2020: 44 · 2019: 20 · 2018: 23 · 2017: 25 · 2016: 22 · 2015: 12 · 2014: 16 · 2013: 5
- FWCI
- 15.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Keywords
- antiphospholipid syndrome, systemic lupus erythematosus, thrombosis, miscarriage, risk score, cardiovascular risk factors, autoantibodies, anti-dsDNA antibodies, anti-ENA antibodies, low-dose aspirin, hydroxychloroquine, oral anticoagulants, risk stratification
- MeSH terms
- Abortion, Spontaneous, Adult, Analysis of Variance, Cardiovascular Diseases, Cross-Sectional Studies, Female, United Kingdom, Humans, Lupus Erythematosus, Systemic, Middle Aged, Pregnancy, Prothrombin, Sensitivity and Specificity, Severity of Illness Index, Thrombosis, Multivariate Analysis, Logistic Models, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Risk Assessment
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