Persistence of antiphospholipid antibodies over time and its association with recurrence of clinical manifestations: A longitudinal study from a single centre |
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| Institution: | 1. Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases (CSUR) of the Spanish Health System, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain;2. Institut d''Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Spain;3. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina 04100, Italy;4. Department of Immunology, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Catalonia, Spain;5. Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain;6. Department of Nephrology and Renal Transplantation, Hospital Clinic, Barcelona, Catalonia, Spain;1. Service de Médecine Intensive-Réanimation, Hôpital Cochin, AP-HP. Centre. 27 rue du Faubourg Saint Jacques, 75014 Paris, France;2. AP-HP, Centre – Université Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, France;3. Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d''Ile de France, Hôpital Cochin, AP-HP, Centre. 27 rue du Faubourg Saint Jacques, 75014 Paris, France;1. Department of Medicine C, Wolfson Medical Center, Israel;2. Sackler Faculty of Medicine, Tel-Aviv University, Israel;3. The Center for Autoimmune Diseases;4. Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center;5. Department of Medicine B;6. Intensive Care Unit, Sheba Medical Center, Israel;7. Nutrition Sciences Department, Ariel University, Israel;8. Ariel University, Ariel, Israel;9. I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia;10. Intensive Care Unit, Wolfson Medical Center, Israel;1. Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan;2. Department of Dermatology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi 491-8558, Japan;1. Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy;3. Department of Medicine, University of Padova, Padova, Italy;4. Geriatric Medicine Unit, Policlinico San Marco Venezia Mestre, Venice, Mestre, Italy;5. Department of Science, University of Basilicata, Potenza, Italy;1. Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy;2. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;3. Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy;4. Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy;5. MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy;6. Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy;7. Rheumatology Clinic ''Madonna Dello Scoglio'' Cotronei, Crotone, Italy;1. School of Medical Sciences, The University of Auckland, Auckland, New Zealand;2. Maurice Wilkins Centre for Biodiscovery, The University of Auckland, Auckland, New Zealand;3. Kidz First Hospital, Counties Manukau Health District, Auckland, New Zealand;4. Department of Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand;5. Starship Children''s Hospital, Auckland Health District, Auckland, New Zealand |
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| Abstract: | PurposeTo analyze the antiphospholipid antibody (aPL) persistence over time in patients with antiphospholipid syndrome (APS) and its association with clinical recurrence and to identify predictors of aPL persistence over time.Patients and methods200 patients with a diagnosis of APS and at least three follow-up aPL determinations were included. Persistent aPL profile was defined as the presence of lupus anticoagulant (LAC) and/or IgG/IgM anticardiolipin (aCL) and/or IgG/IgM anti-β2 glycoprotein-I (aβ2GPI) (> 99th percentile) antibodies in at least 66% of follow-up measurements. Multilevel mixed-effect generalized linear models with logit link were used.Results112 (56%) patients maintained persistent aPL profiles over time, while 88 (44%) were transient. Median follow-up time was 172.5 months. Follow-up time did not affect the odds of aPL persistence in multivariate analysis (p = 1.00). Baseline triple aPL positivity OR 78 (95%CI 16.9–359.7, p < 0.001)] and double aPL positivity OR = 7.6 (95%CI 3.7–15.7, p < 0.001)] correlated with persistent aPLs over time, while isolated LAC OR = 0.26 (95% CI 0.08–0.49, p = 0.002)] or isolated IgG/IgM aCL OR = 0.20 (95% CI 0.11–0.59, p = 0.004)] positivity, were predictors of transient aPL profile. Patients with persistent aPLs had higher rate of clinical recurrence in comparison to patients with transient aPLs OR = 2.48 (95%CI 1.34–4.58, p = 0.003)].ConclusionsMore than half of patients with baseline medium-high titer aPL positivity had persistent positive aPLs over time. Patients with persistent aPLs were more prone to present recurrence of clinical manifestations. Multiple aPL positivity increased the odds of a persistent aPL profile over time, while isolated LAC and aCL positivity decreased it. |
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