Jaume Alijotas-Reig1, Enrique Esteve-Valverde2, Raquel Ferrer-Oliveras3, Elisa LLurba4, Amelia Ruffatti5, Angela Tincani6, Elmina Lefkou7, Mª Tiziana Bertero8, Gerard Espinosa9, Sara de Carolis10, Patrizia Rovere-Querini11, Krista Lundelin12, Elisa Picardo13, Arsene Mekinian14. 1. Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autonoma, Barcelona, Spain. Electronic address: jalijotas@vhebron.net. 2. Internal Medicine Department, Althaia Healthcare Network of Manresa, Rheumatology Unit, Barcelona, Spain. 3. Obstetrics and Gynaecology Department, High Risk Unit, Vall d'Hebron University Hospital, Universitat Autonoma, Barcelona, Spain. Electronic address: raquelfo22@hotmail.com. 4. Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 5. Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua, Italy. 6. Rheumatology and Clinical Immunology Unit, Ospedale Civile, Brescia, Italy. 7. Haematology Unit, Hippokration Hospital of Thessaloniki, Greece. 8. Department of Clinical Immunology, A.O. Mauriziano-Umberto I, Turin, Italy. 9. Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain. 10. Department of Gynaecology, Gemmeli Hospital, Catholic University, Roma, Italy. 11. Scuola di Specializzazione in Allergologia e Immunolofia Clinica, U.O. Medicina ad indrizzo Immunlogico Clinico-Ospedale San Raffaele, Milano, Lab, Autoimminità e inflammazione vascolare - San Raffaele DIBIT, Milano, Italy. 12. Internal Medicine Department, Hospital Universitario La Paz, Universidad Autònoma, Madrid, Spain. 13. Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy. 14. AP-HP, Hôpital Saint-Antoine, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ Paris 06, F-75012, Paris, France.
Abstract
BACKGROUND AND OBJECTIVES: To compare clinical, laboratory, treatment and live birth rate data between women with aPL-related obstetric complications (OMAPS) not fulfilling the Sydney criteria and women fulfilling them (OAPS). MATERIALS AND METHODS: Retrospective and prospective multicentre study. Data comparison between groups from The European Registry on Antiphospholipid Syndrome included within the framework of the European Forum on Antiphospholipid Antibody projects. RESULTS: 338 women were analysed: 247 fulfilled the Sydney criteria (OAPS group) and 91 did not (OMAPS group). In the OMAPS group, 24/91 (26.37%) fulfilled laboratory Sydney criteria (subgroup A) and 67/91 (74.63%) had a low titre and/or non-persistent aPL-positivity (subgroup B). Overall, aPL laboratory categories in OAPS vs. OMAPS showed significant differences: 34% vs. 11% (p<0.0001) for category I, 66% vs. 89% (p<0.0001) for category II. No differences were observed when current obstetric complications were compared (p=0.481). 86.20% of OAPS women were treated vs. 75.82% of OMAPS (p=0.0224), particularly regarding the LDA+LMWH schedule (p=0.006). No differences between groups were observed in live births, gestational, puerperal arterial and/or venous thrombosis. CONCLUSIONS: Significant differences were found among aPL categories between groups. Treatment rates were higher in OAPS. Both OAPS and OMAPS groups had similarly good foetal-maternal outcomes when treated. The proposal to modify OAPS classification criteria, mostly laboratory requirements, is reinforced by these results.
BACKGROUND AND OBJECTIVES: To compare clinical, laboratory, treatment and live birth rate data between women with aPL-related obstetric complications (OMAPS) not fulfilling the Sydney criteria and women fulfilling them (OAPS). MATERIALS AND METHODS: Retrospective and prospective multicentre study. Data comparison between groups from The European Registry on Antiphospholipid Syndrome included within the framework of the European Forum on Antiphospholipid Antibody projects. RESULTS: 338 women were analysed: 247 fulfilled the Sydney criteria (OAPS group) and 91 did not (OMAPS group). In the OMAPS group, 24/91 (26.37%) fulfilled laboratory Sydney criteria (subgroup A) and 67/91 (74.63%) had a low titre and/or non-persistent aPL-positivity (subgroup B). Overall, aPL laboratory categories in OAPS vs. OMAPS showed significant differences: 34% vs. 11% (p<0.0001) for category I, 66% vs. 89% (p<0.0001) for category II. No differences were observed when current obstetric complications were compared (p=0.481). 86.20% of OAPSwomen were treated vs. 75.82% of OMAPS (p=0.0224), particularly regarding the LDA+LMWH schedule (p=0.006). No differences between groups were observed in live births, gestational, puerperal arterial and/or venous thrombosis. CONCLUSIONS: Significant differences were found among aPL categories between groups. Treatment rates were higher in OAPS. Both OAPS and OMAPS groups had similarly good foetal-maternal outcomes when treated. The proposal to modify OAPS classification criteria, mostly laboratory requirements, is reinforced by these results.
Authors: Gayane Manukyan; Anush Martirosyan; Ludek Slavik; Jana Ulehlova; Martin Dihel; Tomas Papajik; Eva Kriegova Journal: Biomedicines Date: 2020-06-15