Antiphospholipid antibody profile stability over time: prospective results from the APS ACTION clinical database and repository
Open accessAbstract
Objective The APS ACTION Registry studies long-term outcomes in persistently antiphospholipid antibody (aPL)-positive patients. Our primary objective was to determine whether clinically meaningful aPL profiles at baseline remain stable over time. Our secondary objectives were to determine (1) whether baseline characteristics differ between patients with stable and unstable aPL profiles, and (2) predictors of unstable aPL profiles over time. Methods A clinically meaningful aPL profile was defined as positive lupus anticoagulant (LAC) test and/or anticardiolipin (aCL)/anti-β2glycoprotein-I (anti–β2-GPI) IgG/M ≥ 40 U. Stable aPL profile was defined as a clinically meaningful aPL profile in at least two-thirds of follow-up measurements. Generalized linear mixed models with logit link were used for primary objective analysis. Results Of 472 patients with clinically meaningful aPL profile at baseline (median follow-up 5.1 yrs), 366/472 (78%) patients had stable aPL profiles over time, 54 (11%) unstable, and 52 (11%) inconclusive. Time did not significantly affect odds of maintaining a clinically meaningful aPL profile at follow-up in univariate (P= 0.906) and multivariable analysis (P= 0.790). Baseline triple aPL positivity decreased (OR 0.25, 95% CI 0.10–0.64,P= 0.004) and isolated LAC test positivity increased (OR 3.3, 95% CI 1.53–7.13,P= 0.002) the odds of an unstable aPL profile over time. Conclusion Approximately 80% of our international cohort patients with clinically meaningful aPL profiles at baseline remain stable at a median follow-up of 5 years; triple aPL-positivity increase the odds of a stable aPL profile. These results will guide future validation studies of stored blood samples through APS ACTION Core Laboratories.
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The 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 [9]
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Experimental — accuracy not yet measuredGkrouzman et al found that approximately 80% of their patients with clinically meaningful aPL at baseline had stable antibodies over time.
“Recent work from Gkrouzman et al found that ∼80% of their patients with clinically meaningful aPL at baseline had stable antibodies, defined by a meaningful antibody profile in two-thirds of testing, over time.9”
From Lupus anticoagulant test persistence over time and its associations with future thrombotic events (2022) · cites this paper as [9]
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MIYAKIS, S., LOCKSHIN, M. D., ATSUMI, T., BRANCH, D. W., BREY, R. L., CERVERA, R., DERKSEN, R. H. W. M., DE GROOT, P. G., KOIKE, T., MERONI, P. L., et al. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2006.01753.x · Cited by 7,203 · see citing works
Self-citationGalli, M., Luciani, D., Bertolini, G., & Barbui, T. (2003) · Blood · doi:10.1182/blood-2002-02-0441 · Cited by 974 · cited 1× · see citing works
“Triple aPL positivity 10,11 or LAC positivity 12 is known to confer a higher risk for aPL-related clinical events compared to aCL and anti–β 2 -GPI positivity.”
BackgroundDiagnosis and management of the antiphospholipid syndrome
Garcia, D., & Erkan, D. (2018) · New England Journal of Medicine · doi:10.1056/nejmra1705454 · Cited by 819 · see citing works
Self-citationClinical course of high‐risk patients diagnosed with antiphospholipid syndrome
PENGO, V., RUFFATTI, A., LEGNANI, C., GRESELE, P., BARCELLONA, D., ERBA, N., TESTA, S., MARONGIU, F., BISON, E., DENAS, G., et al. (2010) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2009.03674.x · Cited by 633 · cited 1× · see citing works
“Triple aPL positivity 10,11 or LAC positivity 12 is known to confer a higher risk for aPL-related clinical events compared to aCL and anti–β 2 -GPI positivity.”
BackgroundSelf-citationPengo, V., Ruffatti, A., Legnani, C., Testa, S., Fierro, T., Marongiu, F., De Micheli, V., Gresele, P., Tonello, M., Ghirarduzzi, A., et al. (2011) · Blood · doi:10.1182/blood-2011-03-340232 · Cited by 465 · cited 1× · see citing works
“Triple aPL positivity 10,11 or LAC positivity 12 is known to confer a higher risk for aPL-related clinical events compared to aCL and anti–β 2 -GPI positivity.”
BackgroundSelf-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
Kelchtermans, H., Pelkmans, L., de Laat, B., & Devreese, K. M. J. (2016) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.13379 · Cited by 131 · see citing works
BRODER, A., & PUTTERMAN, C. (2013) · The Journal of Rheumatology · doi:10.3899/jrheum.120157 · Cited by 101 · cited 1× · see citing works
“…and persistently positive aPL profiles (positive LAC and/or an aCL/anti–β 2 -GPI ≥ 40 U) were less likely to be taking HCQ compared to patients with transiently positive or negative profiles 14 ; HCQ may also decrease aCL IgG/M levels and dRVVT (dilute Russell Viper Venom Time) prolongation 15 .”
BackgroundPengo, V., Ruffatti, A., Del Ross, T., Tonello, M., Cuffaro, S., Hoxha, A., Banzato, A., Bison, E., Denas, G., Bracco, A., et al. (2013) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.12264 · Cited by 101 · see citing works
Self-citationMartinez-Berriotxoa, A., Ruiz-Irastorza, G., Egurbide, M.-V., Garmendia, M., Gabriel Erdozain, J., Villar, I., & Aguirre, C. (2007) · Lupus · doi:10.1177/0961203307083316 · Cited by 77 · see citing works
Real world experience with antiphospholipid antibody tests: how stable are results over time?
Erkan, D., Derksen, W. J. M., Kaplan, V, Sammaritano, L., Pierangeli, S. S., Roubey, R., & Lockshin, M. D. (2005) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2004.031856 · Cited by 76 · see citing works
Self-citationFavaloro, E. J., Mohammed, S., Curnow, J., & Pasalic, L. (2019) · Pathology · doi:10.1016/j.pathol.2018.11.008 · Cited by 67 · see citing works
ISTH guidelines on Lupus Anticoagulant testing
Pengo, V. (2012) · Thrombosis Research · doi:10.1016/j.thromres.2012.08.283 · Cited by 55 · see citing works
Self-citationSciascia, S., Radin, M., Cecchi, I., Rubini, E., Scotta, A. M., Rolla, R., Montaruli, B., Pergolini, P., Mengozzi, G., Muccini, E., et al. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00376 · Cited by 46 · see citing works
Self-citationDevignes, J., Smaïl‐Tabbone, M., Hervé, A., Cagninacci, G., Devignes, M., Lecompte, T., Zuily, S., & Wahl, D. (2019) · International Journal of Laboratory Hematology · doi:10.1111/ijlh.13094 · Cited by 27 · see citing works
Serological evolution in women with positive antiphospholipid antibodies
Riancho‐Zarrabeitia, L., Daroca, G., Muñoz, P., López‐Hoyos, M., Haya, A., & Martínez-Taboada, V. M. (2017) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2017.05.001 · Cited by 24 · see citing works
Anti-phospholipid Antibodies and Smoking: An Overview
Binder, S. R., & Litwin, C. M. (2016) · Clinical Reviews in Allergy & Immunology · doi:10.1007/s12016-016-8565-4 · Cited by 21 · see citing works
Diagnosis and management of antiphospholipid syndrome
Heuser, C. C., & Branch, W. D. (2018) · doi:10.1002/9781119072980.ch31 · Cited by 20 · see citing works
Udry, S., Latino, J. O., Belizna, C. C., Wingeyer, S. D. P., Romero, D. S. F., & Larrañaga, G. F. D. (2019) · Immunologic Research · doi:10.1007/s12026-019-09110-x · Cited by 13 · see citing works
Shariati‐Sarabi, Z., Sahebari, M., Rezaie, A. E., et al. (2018) · Current Rheumatology Reviews · doi:10.2174/1573397113666161122152553 · Cited by 8 · see citing works
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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
“This corresponded to 10-year prospective ATE, VTE, and overall thrombosis incidences of 14% (95%CI: 9-21), 20% (13-28), and 34% (26-43), respectively, and a 10-year mortality of 14% (9-22) (supplemental Figure 2).”
Background
- Authors
- Gkrouzman, E., Sevim, E., Finik, J., Andrade, D., Pengo, V., Sciascia, S., Tektonidou, M. G., Ugarte, A., Chighizola, C. B., Belmont, H. M., Lopez-Pedrera, C., Ji, L., Fortin, P., Efthymiou, M., de Jesus, G. R., Branch, D. W., Nalli, C., Petri, M., Rodriguez, E., Cervera, R., Knight, J. S., Atsumi, T., Willis, R., Bertolaccini, M. L., Cohen, H., Rand, J., Erkan, D., & ACTION+, O. B. O. A.
- Affiliations
- Hospital for Special Surgery (US)
- Albert Einstein College of Medicine (US)
- Memorial Sloan Kettering Cancer Center (US)
- Universidade de São Paulo (BR)
- University of Padua (IT)
- University of Turin (IT)
- National and Kapodistrian University of Athens (GR)
- Hospital de Cruces (ES)
- IRCCS Istituto Auxologico Italiano (IT)
- New York University Langone Orthopedic Hospital (US)
- Peking University First Hospital (CN)
- CHU de Québec-Université Laval (CA)
- University College London (GB)
- Intermountain Healthcare (US)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Johns Hopkins University (US)
- Hospital Clínic de Barcelona (ES)
- University of Michigan (US)
- Hokkaido University Hospital (JP)
- The University of Texas Medical Branch at Galveston (US)
- Weill Cornell Medicine (US)
- ORCID
- Gkrouzman, Elena
- Sevim, Ecem
- Andrade, Danieli
- Pengo, Vittorio
- Sciascia, Savino
- Tektonidou, Maria G.
- Chighizola, Cecilia B.
- Belmont, H. Michael
- Lopez-Pedrera, Chary
- Ji, Lanlan
- Fortin, Paul
- Efthymiou, Maria
- de Jesus, Guilherme Ramires
- Branch, D. Ware
- Nalli, Cecilia
- Petri, Michelle
- Cervera, Ricard
- Knight, Jason S.
- Atsumi, Tatsuya
- Willis, Rohan
- Bertolaccini, Maria Laura
- Cohen, Hannah
- Rand, Jacob
- Erkan, Doruk
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2020-09-01
- Volume
- 48
- Issue
- 4
- Pages
- 541-547
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- PMC
- PMC10727093
- OpenAlex
- W3081515883
- Cited by
- 24
- References
- 20
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 3
- FWCI
- 3.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Johns Hopkins University
- British Heart Foundation (RE/18/2/34213)
- National Institutes of Health (UL1TR000457, TR000457, TR002384, UL1TR002384)
- Weill Cornell Medical College (UL1TR002384, UL1 TR000457)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR069572)
- National Center for Advancing Translational Sciences
- Clinical and Translational Science Center, Weill Cornell Medical College (TR002384, UL1 TR000457, UL1 TR002384)
- 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 antibodies, antiphospholipid syndrome, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies
- MeSH terms
- Humans, Prospective Studies, Cohort Studies, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, beta 2-Glycoprotein I
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