TY - JOUR
T1 - Antiphospholipid antibody profile stability over time
T2 - Prospective results from the APS ACTION clinical database and repository
AU - Gkrouzman, Elena
AU - Sevim, Ecem
AU - Finik, Jackie
AU - Andrade, Danieli
AU - Pengo, Vittorio
AU - Sciascia, Savino
AU - Tektonidou, Maria G.
AU - Ugarte, Amaia
AU - Chighizola, Cecilia B.
AU - Belmont, H. Michael
AU - Lopez-Pedrera, Chary
AU - Ji, Lanlan
AU - Fortin, Paul
AU - Efthymiou, Maria
AU - de Jesus, Guilherme Ramires
AU - Branch, D. Ware
AU - Nalli, Cecilia
AU - Petri, Michelle
AU - Rodriguez, Esther
AU - Cervera, Ricard
AU - Knight, Jason S.
AU - Atsumi, Tatsuya
AU - Willis, Rohan
AU - Bertolaccini, Maria Laura
AU - Cohen, Hannah
AU - Rand, Jacob
AU - Erkan, Doruk
N1 - Publisher Copyright:
© 2021 Journal of Rheumatology. All rights reserved.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - 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-β2 glycoprotein-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.
AB - 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-β2 glycoprotein-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.
KW - Anticardiolipin antibodies
KW - Antiphospholipid antibodies
KW - Antiphospholipid syndrome
UR - http://www.scopus.com/inward/record.url?scp=85104683440&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85104683440&partnerID=8YFLogxK
U2 - 10.3899/JRHEUM.200513
DO - 10.3899/JRHEUM.200513
M3 - Review article
C2 - 33259328
AN - SCOPUS:85104683440
SN - 0315-162X
VL - 48
SP - 541
EP - 547
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 4
ER -