Savino Sciascia1,2, Massimo Radin1, Giovanni Sanna3, Irene Cecchi1, Dario Roccatello1,2, Maria Laura Bertolaccini4. 1. Center of Research of Immunopathology and Rare Diseases - Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and S. Giovanni Bosco Hospital Turin, Italy. 2. Nephrology and Dialysis Unit, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Turin, Italy. 3. Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK. 4. Academic Department of Vascular Surgery, Cardiovascular Division, King's College London, London, UK.
Abstract
Objective: Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation. Methods: We pooled data from available cohort studies, including a total of 10 studies, comprising 2273 patients, in which the GAPSS has been applied. A search strategy was developed a priori to identify an available cohort that reported findings which investigated the clinical utility of GAPSS or aGAPSS. Results: Seven studies used the GAPSS in their cohort, whereas three studies used the aGAPSS. In brief, we found a statistically significant difference in the cumulative GAPSS and aGAPSS between patients that experienced an arterial and/or venous thrombotic event [cumulative mean GAPSS (s.d.) 10.6 (4.74) and aGAPSS 7.6 (3.95)], patients without any thrombotic manifestation [cumulative GAPSS 7.01 (5.46) and aGAPSS 4.9 (4.33)] and patients with pregnancy morbidity [cumulative GAPSS 8.79 (2.59) and aGAPSS 6.7 (2.8)]. The highest levels of GAPSS were found in patients that experienced arterial thrombosis [mean GAPSS 12.2 (5.2)] and patients that experienced any recurrences of clinical manifestations of APS [mean GAPSS 13.7 (3.1)]. Conclusion: GAPSS may represent a useful tool to assess the thrombosis or pregnancy loss risk in aPL-positive patients, switching from the concept of aPL as a sole diagnostic antibody to aPL as risk factors for clinical events.
Objective: Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation. Methods: We pooled data from available cohort studies, including a total of 10 studies, comprising 2273 patients, in which the GAPSS has been applied. A search strategy was developed a priori to identify an available cohort that reported findings which investigated the clinical utility of GAPSS or aGAPSS. Results: Seven studies used the GAPSS in their cohort, whereas three studies used the aGAPSS. In brief, we found a statistically significant difference in the cumulative GAPSS and aGAPSS between patients that experienced an arterial and/or venous thrombotic event [cumulative mean GAPSS (s.d.) 10.6 (4.74) and aGAPSS 7.6 (3.95)], patients without any thrombotic manifestation [cumulative GAPSS 7.01 (5.46) and aGAPSS 4.9 (4.33)] and patients with pregnancy morbidity [cumulative GAPSS 8.79 (2.59) and aGAPSS 6.7 (2.8)]. The highest levels of GAPSS were found in patients that experienced arterial thrombosis [mean GAPSS 12.2 (5.2)] and patients that experienced any recurrences of clinical manifestations of APS [mean GAPSS 13.7 (3.1)]. Conclusion: GAPSS may represent a useful tool to assess the thrombosis or pregnancy loss risk in aPL-positive patients, switching from the concept of aPL as a sole diagnostic antibody to aPL as risk factors for clinical events.
Authors: María Del Carmen Zamora-Medina; Andrea Hinojosa-Azaola; Carlos A Nuñez-Alvarez; Angel Gabriel Vargas-Ruiz; Juanita Romero-Diaz Journal: Clin Rheumatol Date: 2018-12-04 Impact factor: 2.980
Authors: Massimo Radin; Savino Sciascia; Doruk Erkan; Vittorio Pengo; Maria G Tektonidou; Amaia Ugarte; Pierluigi Meroni; Lanlan Ji; H Michael Belmont; Hannah Cohen; Guilherme Ramires de Jesús; D Ware Branch; Paul R Fortin; Laura Andreoli; Michelle Petri; Esther Rodriguez; Ignasi Rodriguez-Pinto; Jason S Knight; Tatsuya Atsumi; Rohan Willis; Emilio Gonzalez; Rosario Lopez-Pedrera; Ana Paula Rossi Gandara; Margarete Borges Gualhardo Vendramini; Alessandra Banzato; Ecem Sevim; Medha Barbhaiya; Maria Efthymiou; Ian Mackie; Maria Laura Bertolaccini; Danieli Andrade Journal: Semin Arthritis Rheum Date: 2019-05-02 Impact factor: 5.532
Authors: Jae Won Kim; Tae Woo Kim; Keon Hee Ryu; Sun Gyoo Park; Chang Young Jeong; Dong Ho Park Journal: J Int Med Res Date: 2020-01 Impact factor: 1.671
Authors: Pavla Bradacova; Ludek Slavik; Jana Ulehlova; Adela Skoumalova; Jana Ullrychova; Jana Prochazkova; Antonin Hlusi; Gayane Manukyan; Eva Kriegova Journal: Biomedicines Date: 2021-02-08
Authors: G R de Jesús; S Sciascia; D Andrade; M Barbhaiya; M Tektonidou; A Banzato; V Pengo; L Ji; P L Meroni; A Ugarte; H Cohen; D W Branch; L Andreoli; H M Belmont; P R Fortin; M Petri; E Rodriguez; R Cervera; J S Knight; T Atsumi; R Willis; I S Nascimento; R Rosa; D Erkan; R A Levy Journal: BJOG Date: 2018-10-24 Impact factor: 6.531