Real world experience with antiphospholipid antibody tests: how stable are results over time?
Open accessAbstract
Objective To determine the stability and the degree of variation of antiphospholipid antibody (aPL) results over time in a large cohort of well evaluated aPL positive patients; and to analyse factors contributing to aPL variation and the validity of aPL in a real world setting in which aPL tests are done in multiple laboratories.Methods The clinical characteristics, drug treatment, and 1652 data points for lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and anti-beta2 glycoprotein I antibodies (anti-beta2GPI) were examined in 204 aPL positive patients; 81 of these met the Sapporo criteria for antiphospholipid syndrome (APS) and 123 were asymptomatic bearers of aPL.Results 87% of initially positive LA results, 88% of initially negative to low positive aCL results, 75% of initially moderate to high positive aCL results, 96% of initially negative to low positive anti-beta2GPI results, and 76% of initially moderate to high positive anti-beta2GPI results subsequently remained in the same range regardless of the laboratory performing the test. Aspirin, warfarin, and hydroxychloroquine use did not differ among patients whose aCL titres significantly decreased or increased or remained stable. On same day specimens, the consistency of aCL results among suppliers ranged from 64% to 88% and the correlation ranged from 0.5 to 0.8. Agreement was moderate for aCL IgG and aCL IgM; however, for aCL IgA agreement was marginal.Conclusions aPL results remained stable for at least three quarters of subsequent tests, regardless of the laboratory performing the test; the small amount of variation that occurred did not appear to be caused by aspirin, warfarin, or hydroxychloroquine use.
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This was the first study to report that hydroxychloroquine use is associated with lower odds of persistently positive lupus anticoagulant and/or antiphospholipid antibodies.
“This is the first study to show that HCQ use is associated with lower odds of having persistently positive LAC and/or aPL Abs.”
From Hydroxychloroquine Use Is Associated with Lower Odds of Persistently Positive Antiphospholipid Antibodies and/or Lupus Anticoagulant in Systemic Lupus Erythematosus (2013) · cites this paper as [6]
The Results report no difference in hydroxychloroquine use between patients whose anticardiolipin antibody titres decreased, increased, or remained stable. The Discussion explicitly says the authors found no relation between hydroxychloroquine treatment and change in titre, rather than an association with lower odds of persistent positivity. Page numbers were not provided for these passages. (LLM, conf=0.91)
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Experimental — accuracy not yet measuredBefore this study, only one published study had examined the relationship between hydroxychloroquine and antiphospholipid antibodies, in a secondary analysis, and it found no association.
“However, only one published study to date evaluated the association between HCQ and aPL Abs in a secondary analysis with a negative result (6).”
From Hydroxychloroquine Use Is Associated with Lower Odds of Persistently Positive Antiphospholipid Antibodies and/or Lupus Anticoagulant in Systemic Lupus Erythematosus (2013) · cites this paper as [6]
The Results report no association between hydroxychloroquine use and changes in anticardiolipin antibody (aCL) titres, and the Discussion says the study was not primarily designed to test that relationship. Our copy does not establish that this was the only published study to examine the association, and its negative finding concerns aCL titres specifically rather than all antiphospholipid antibodies. The indexed passages provide no page numbers. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe proportion of patients in the cohort who remained persistently LA+ (72%) was similar to rates in other studies that used different definitions of LA stability and positivity (78% in Gkrouzman et al, 71% in Zen et al, and 87% in Erkan et al).
“However, the proportion of patients in our cohort who remained persistently LA+ (72%) was similar to the rates in other studies that used different definitions of LA stability and positivity (78% in the study by Gkrouzman et al, 71% in the study by Zen et al, and 87% in study by Erkan et al.).9,10,36”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [36]
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Experimental — accuracy not yet measuredThis finding contrasts with Erkan et al, who found that more than three-quarters of subsequent tests of lupus anticoagulant were consistent with baseline test results, regardless of the laboratory.
“This contrasts with the results of Erkan et al,13 who found that more than three-quarters of subsequent tests of lupus anticoagulant were consistent with baseline test results, regardless of the laboratory.”
From Evaluation of different ways to identify persistent positivity of lupus anticoagulant in systemic lupus erythematosus (2020) · cites this paper as [13]
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Cites
Brandt, J. T., Triplett, D. A., Alving, B. M., & Scharrer, I. (1995) · PubMed · Cited by 1,164 · see citing works
Brandt, J. T., Triplett, D. A., Alving, B., & Scharrer, I. (1995) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1649901 · Cited by 993 · see citing works
Galli, M., Luciani, D., Bertolini, G., & Barbui, T. (2003) · Blood · doi:10.1182/blood-2002-02-0441 · Cited by 974 · cited 1× · see citing works
“studies showing that a positive LA test is more commonly associated with thrombosis than is aCL (14), and that dual positivity of aCL and LA test is more commonly associated with thrombosis than is single positivity of aCL or LA test (15).”
BackgroundAnticardiolipin Antibodies and the Risk for Ischemic Stroke and Venous Thrombosis
Ginsburg, K. S., Liang, M. H., Newcomer, L., Goldhaber, S. Z., Schur, P. H., Hennekens, C. H., & Stampfer, M. J. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-12-997 · Cited by 526 · see citing works
Harris, E. N. (1990) · American Journal of Clinical Pathology · doi:10.1093/ajcp/94.4.476 · Cited by 416 · see citing works
Prevalence, Follow-Up and Clinical Significance of the Anticardiolipin Antibodies in Normal Subjects
Vila, P., Hernández, M. C., Fernández, M. F. L., & Batlle, J. (1994) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1648840 · Cited by 279 · see citing works
Prednisone does not prevent recurrent fetal death in women with antiphospholipid antibody
Lockshin, M. D., Druzin, M. L., & Qamar, T. (1989) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(89)90468-7 · Cited by 267 · see citing works
Self-citationLevine, S. R., Salowich‐Palm, L., Sawaya, K. L., Perry, M., Spencer, H. J., Winkler, H. J., Alam, Z., & Carey, J. L. (1997) · Stroke · doi:10.1161/01.str.28.9.1660 · Cited by 212 · see citing works
KALUNIAN, K. C., Middlekauff, H. R., Sayre, J. A., Ando, D. G., Mangotich, M., Hahn, B. H., & Peter, J. B. (1988) · The American Journal of Medicine · doi:10.1016/s0002-9343(88)80229-8 · Cited by 150 · see citing works
Reber, G., Schousboe, I., Tincani, A., Sanmarco, M., Kveder, T., de Moerloose, P., Boffa, M., & Arvieux, J. (2002) · PubMed · Cited by 119 · see citing works
Inter-laboratory Variability of Anti-β2-glycoprotein I Measurement
Schousboe, I., Tincani, A., Sanmarco, M., Kveder, T., de Moerloose, P., Boffa, M., Arvieux, J., & Reber, G. (2002) · Thrombosis and Haemostasis · doi:10.1055/s-0037-1613156 · Cited by 90 · see citing works
The Italian Registry of Antiphospholipid Antibodies.
Finazzi, G. (1997) · PubMed · Cited by 79 · see citing works
Bruce, I. N., Clark-Soloninka, C. A., Spitzer, K. A., Gladman, D. D., Urowitz, M. B., & Laskin, C. A. (2000) · PubMed · Cited by 52 · see citing works
Does the anti-β2-glycoprotein I antibody provide additional information in patients with thrombosis?
Lee, E. Y., Lee, C.-K., Lee, T. H., Chung, S. M., Kim, S. H., Cho, Y. S., Yoo, B., & Moon, H.-B. (2003) · Thrombosis Research · doi:10.1016/j.thromres.2003.08.023 · Cited by 47 · see citing works
Risk of arterial thrombosis in patients with anticardiolipin antibodies and lupus anticoagulant
Nojima, J., Suehisa, E., Akita, N., et al. (1997) · British Journal of Haematology · doi:10.1046/j.1365-2141.1997.d01-2055.x · Cited by 46 · see citing works
Out, H. J., van Vliet, M., de Groot, P. G., & Derksen, R. H. (1992) · Annals of the Rheumatic Diseases · doi:10.1136/ard.51.3.353 · Cited by 42 · see citing works
Consensus guidelines for anticardiolipin antibody testing
Wong, R. C. W. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.06.002 · Cited by 40 · see citing works
AUDRAIN, M. A. P. (2003) · British journal of rheumatology · doi:10.1093/rheumatology/keh029 · Cited by 35 · see citing works
Anticardiolipin Antibodies and the Risk for Ischemic Stroke and Venous Thrombosis
&NA; (1993) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-199309000-00006 · Cited by 29 · see citing works
Antiphospholipid antibodies and thrombosis: do test patterns identify the patients' risk?
Galli, M. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.08.009 · Cited by 22 · see citing works
Wong, R. C. W., Wilson, R. J., Pollock, W., Steele, R. H., & Gillis, D. (2004) · Pathology · doi:10.1080/00313020410001672046 · Cited by 21 · see citing works
KALUNIAN, K. C., PETER, J., Middlekauff, H. R., et al. (1988) · The American Journal of Medicine · doi:10.1016/0002-9343(88)90679-1 · Cited by 3 · see citing works
Wilson (1999) · doi:10.1002/1529-0131(199907)42:7
Flagged first, then by citations
Research works printed but not linked: 3
- Roubey RAS, Buxton G, APSCORE Investigators. The Antiphospholipid Syndrome Collaborative Registry (APSCORE): report on the first 546 subjects [abstract]. Arthritis Rheum 2004;50:S640.
- Erkan D, Sammaritano L, Levy R, Harrison MJ, Peterson M, Yazici Y, et al. APLASA study 2004 update: primary thrombosis prevention in asymptomatic aPL-positive patients with aspirin (ASA) [abstract]. Arthritis Rheum 2004;50:S640-41.
- Erkan D, Sammaritano L, Yazici Y, Lockshin MD. Challenging clinical aspects of antiphospholipid syndrome: what do experts say? [abstract] Arthritis Rheum, 2001;44:S147.
Cited by
Sorted by citations
Lockshin, M. D., Kim, M., Laskin, C. A., Guerra, M., Branch, D. W., Merrill, J., Petri, M., Porter, T. F., Sammaritano, L., Stephenson, M. D., et al. (2012) · Arthritis & Rheumatism · doi:10.1002/art.34402 · Cited by 388 · see citing works
Self-citationRand, J. H., Wu, X.-X., Quinn, A. S., Chen, P. P., Hathcock, J. J., & Taatjes, D. J. (2008) · Blood · doi:10.1182/blood-2008-03-144204 · Cited by 215 · see citing works
Kravvariti, E., Koutsogianni, A., Samoli, E., Sfikakis, P. P., & Tektonidou, M. G. (2020) · Autoimmunity Reviews · doi:10.1016/j.autrev.2020.102491 · Cited by 112 · see citing works
BRODER, A., & PUTTERMAN, C. (2013) · The Journal of Rheumatology · doi:10.3899/jrheum.120157 · Cited by 101 · see citing works
Gkrouzman, E., Sevim, E., Finik, J., Andrade, D., Pengo, V., Sciascia, S., Tektonidou, M. G., Ugarte, A., Chighizola, C. B., Belmont, H. M., et al. (2021) · The Journal of Rheumatology · doi:10.3899/jrheum.200513 · Cited by 24 · see citing works
Self-citationPetri, M. A., Avci, M., & Magder, L. S. (2020) · Lupus Science & Medicine · doi:10.1136/lupus-2020-000406 · Cited by 6 · see citing works
Lupus anticoagulant test persistence over time and its associations with future thrombotic events
Colling, M. E., Ay, C., Kraemmer, D., Koder, S., Quehenberger, P., Pabinger, I., Posch, F., & Gebhart, J. (2022) · Blood Advances · doi:10.1182/bloodadvances.2021006011 · Cited by 5 · see citing works
“Age at entry, years (IQR) 164 (0%) 41 (31-58)”
Background
- Authors
- Erkan, D., Derksen, W. J. M., Kaplan, V, Sammaritano, L., Pierangeli, S. S., Roubey, R., & Lockshin, M. D.
- Affiliations
- Hospital for Special Surgery (US)
- University of Groningen (NL)
- Morehouse School of Medicine (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Erkan, D
- ORCID
- Erkan, D
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2005-09
- Volume
- 64
- Issue
- 9
- Pages
- 1321-1325
- ISSN
- 0003-4967 (ISSN-L)
- PMC
- PMC1755632
- OpenAlex
- W2048723083
- Cited by
- 76
- References
- 23
- Citations by year
- 2026: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 7 · 2019: 2 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 7 · 2012: 9
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Arthritis Foundation
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Keywords
- antiphospholipid antibodies, antiphospholipid syndrome, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, interlaboratory agreement, aspirin, warfarin, hydroxychloroquine, Sapporo criteria
- MeSH terms
- Adult, Female, Glycoproteins, Humans, Male, Middle Aged, Reproducibility of Results, Cohort Studies, Biomarkers, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin, beta 2-Glycoprotein I
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