Ozan Unlu1, Doruk Erkan1, Medha Barbhaiya1, Danieli Andrade2, Iana Nascimento2, Renata Rosa2, Alessandra Banzato3, Vittorio Pengo3, Amaia Ugarte4, Maria Gerosa5, Lanlan Ji6, Maria Efthymiou7, D Ware Branch8, Guilherme Ramires de Jesus9, Angela Tincani10, H Michael Belmont11, Paul R Fortin12, Michelle Petri13, Esther Rodriguez14, Guillermo J Pons-Estel15, Jason S Knight16, Tatsuya Atsumi17, Rohan Willis17, Stephane Zuily18, Maria G Tektonidou19. 1. Weill Cornell Medicine, New York, New York. 2. University of Sao Paulo, Sao Paulo, Brazil. 3. University Hospital Padova, Padova, Italy. 4. Hospital Universitario Cruces Bizkaia, Spain. 5. University of Milan, Milan, Italy. 6. Peking University First Hospital, Beijing, China. 7. University College London, London, UK. 8. University of Utah and Intermountain Healthcare, Salt Lake City. 9. State University of Rio de Janeiro, Rio de Janeiro, Brazil. 10. University of Brescia, Brescia, Italy. 11. NYU School of Medicine Langone Medical Center, New York, New York. 12. Université Laval, Quebec City, Quebec, Canada. 13. Johns Hopkins University, Baltimore, Maryland. 14. Hospital Universitario 12 de Octubre, Madrid, Spain. 15. Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Catalonia, Spain. 16. University of Michigan, Ann Arbor. 17. Hokkaido University Hospital, Sapporo, Japan. 18. Nancy University, Nancy, France. 19. National and Kapodistrian University of Athens, Athens, Greece.
Abstract
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist regarding the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective of this study was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with SLE with those of aPL-positive patients without SLE. METHODS: A secure web-based data capture system was used to store patient demographic characteristics and aPL-related clinical and laboratory characteristics. Inclusion criteria included positive aPL according to the updated Sapporo classification criteria. Antiphospholipid antibody-positive patients fulfilling the American College of Rheumatology criteria for the classification of SLE ("aPL with SLE") and those with no other autoimmune diseases ("aPL only") were included in the analysis. RESULTS: Six hundred seventy-two aPL-positive patients were recruited from 24 international centers; 426 of these patients did not have other autoimmune disease, and 197 had SLE. The frequency of thrombocytopenia, hemolytic anemia, low complement levels, and IgA anti-β2 -glycoprotein I (anti-β2 GPI) antibodies was higher in the aPL-positive patients with SLE, whereas the frequency of cognitive dysfunction and IgG anti-β2 GPI antibodies was higher in the aPL-only group. The frequency of arterial and venous thromboses (including recurrent) as well as pregnancy morbidity was similar in the 2 groups. The prevalence of cardiovascular disease risk factors at the time of entry into the registry entry did not differ between the 2 groups, with the exception of current smoking, which was more frequent in aPL-positive patients with SLE. CONCLUSION: Although the frequencies of thrombosis and pregnancy morbidity are similar in aPL-positive patients with and those without SLE, the diagnosis of SLE in patients with persistently positive aPL is associated with an increased frequency of thrombocytopenia, hemolytic anemia, low complement levels, and positive IgA anti-β2 GPI antibodies.
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist regarding the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective of this study was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with SLE with those of aPL-positive patients without SLE. METHODS: A secure web-based data capture system was used to store patient demographic characteristics and aPL-related clinical and laboratory characteristics. Inclusion criteria included positive aPL according to the updated Sapporo classification criteria. Antiphospholipid antibody-positive patients fulfilling the American College of Rheumatology criteria for the classification of SLE ("aPL with SLE") and those with no other autoimmune diseases ("aPL only") were included in the analysis. RESULTS: Six hundred seventy-two aPL-positive patients were recruited from 24 international centers; 426 of these patients did not have other autoimmune disease, and 197 had SLE. The frequency of thrombocytopenia, hemolytic anemia, low complement levels, and IgA anti-β2 -glycoprotein I (anti-β2 GPI) antibodies was higher in the aPL-positive patients with SLE, whereas the frequency of cognitive dysfunction and IgG anti-β2 GPI antibodies was higher in the aPL-only group. The frequency of arterial and venous thromboses (including recurrent) as well as pregnancy morbidity was similar in the 2 groups. The prevalence of cardiovascular disease risk factors at the time of entry into the registry entry did not differ between the 2 groups, with the exception of current smoking, which was more frequent in aPL-positive patients with SLE. CONCLUSION: Although the frequencies of thrombosis and pregnancy morbidity are similar in aPL-positive patients with and those without SLE, the diagnosis of SLE in patients with persistently positive aPL is associated with an increased frequency of thrombocytopenia, hemolytic anemia, low complement levels, and positive IgA anti-β2 GPI antibodies.
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Authors: Stéphane Zuily; Isabelle Clerc-Urmès; Cédric Bauman; Danieli Andrade; Savino Sciascia; Vittorio Pengo; Maria G Tektonidou; Amaia Ugarte; Maria Gerosa; H Michael Belmont; Maria Angeles Aguirre Zamorano; Paul Fortin; Lanlan Ji; Maria Efthymiou; Hannah Cohen; D Ware Branch; Guilherme Ramires de Jesus; Cecilia Nalli; Michelle Petri; Esther Rodriguez; Ricard Cervera; Jason S Knight; Tatsuya Atsumi; Rohan Willis; Maria Laura Bertolaccini; Joann Vega; Denis Wahl; Doruk Erkan Journal: Lupus Date: 2020-07-23 Impact factor: 2.911
Authors: Oscar Cabrera-Marante; Edgard Rodríguez de Frías; Manuel Serrano; Fernando Lozano Morillo; Laura Naranjo; Francisco J Gil-Etayo; Estela Paz-Artal; Daniel E Pleguezuelo; Antonio Serrano Journal: Int J Mol Sci Date: 2020-11-26 Impact factor: 5.923
Authors: Lina-Marcela Diaz-Gallo; Vilija Oke; Emeli Lundström; Kerstin Elvin; Yee Ling Wu; Susanna Eketjäll; Agneta Zickert; Johanna T Gustafsson; Andreas Jönsen; Dag Leonard; Daniel J Birmingham; Gunnel Nordmark; Anders A Bengtsson; Lars Rönnblom; Iva Gunnarsson; Chack-Yung Yu; Leonid Padyukov; Elisabet Svenungsson Journal: ACR Open Rheumatol Date: 2021-10-17