Extended persistence of antiphospholipid antibodies beyond the 12‐week time interval: association with baseline antiphospholipid antibodies titres
Open accessAbstract
INTRODUCTION: The confirmation time interval for the presence of antiphospholipid antibodies (aPL) has been extended to 12 weeks as epiphenomenal antibodies may disappear after 6 weeks. Our aim was to analyse extended persistence of aPL positivity beyond the 12-week interval. METHODS: We retrospectively analysed our database of 23 856 aPL test samples collected between 2005 and 2017 from 17 367 consecutive patients. Two groups of patients were identified among aPL-positive patients, confirmed at 12 weeks: with or without extended persistence beyond confirmatory testing. Percentages of extended persistence are given according to the initial aPL positivity profiles, and baseline laboratory variables are compared between the two groups. RESULTS: Three hundred and twenty-seven patients confirmed aPL-positive had subsequent testing. The vast majority of them displayed extended persistence in the long term: 89.6% and up to 97.9% for patients with initial triple positivity. In extended persistent positive patients, there were more LA-positive initial samples, and baseline LA test values and IgG aCL titres were higher than in nonpersistent positive patients. CONCLUSION: Data from a large database of an aPL referral laboratory showed that the time interval of 12 weeks defining persistence of aPL positivity was appropriate for the majority of patients. Furthermore, we found baseline features associated with extended persistence.
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A retrospective study found extended aPL persistence in 96% of patients over a median 56-week follow-up, with single-positive patients not significantly less persistent than double- or triple-positive patients.
“A retrospective study evaluated extended persistence and demonstrated persistence in 96% in a median follow-up of 56 weeks, with no significant lower persistence in the single positive patients compared with the double and triple positives.80”
These findings favor lengthening the retest interval past 12 weeks so that patients still positive after that point can be identified.
“These results support the choice of extending the retest interval beyond 12 weeks, which would identify patients who remain persistently positive even beyond this period.80”
Since most triple-positive patients remain triple positive, their confirmation appears predictable without a 12-week retest.
“Confirmation of triple-positive patients (same isotype 81 or independent of isotype of aCL and aβ2GPI 80 ) seems to be predictable without the need to retest after 12 weeks because triplepositivity persists in the majority of patients.80,81”
Others found no significant lower persistence in single-positive patients (93.3%) compared with double- and triple-positive patients (96.8 and 97.9%, respectively).
“Others found no significant lower persistence in the single-positive patients (93.3%) compared with the doubleand triple-positive patients(96.8and97.9%,respectively). 22”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [22]
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- Authors
- Devignes, J., Smaïl‐Tabbone, M., Hervé, A., Cagninacci, G., Devignes, M., Lecompte, T., Zuily, S., & Wahl, D.
- Affiliations
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- Centre National de la Recherche Scientifique (FR)
- University of Geneva (CH)
- Inserm (FR)
- Corresponding author
- Devignes, Jean
- ORCID
- Venue
- International Journal of Laboratory Hematology
- Publisher
- Wiley
- Published
- 2019-09-15
- Volume
- 41
- Issue
- 6
- Pages
- 726-730
- ISSN
- 1751-5521 (ISSN-L)
- 1751-553X
- OpenAlex
- W2973486753
- Cited by
- 27
- References
- 10
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 11
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- green
- inria.hal.science
- Licence
- Locations
- International Journal of Laboratory Hematology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Funders
- Association des Chefs de Service
- Contrat de Plan Etat-Region (IT2MP)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- antiphospholipid antibodies, anticardiolipin antibodies, antiphospholipid syndrome
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid
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