The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus

The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL) in a cohort of systemic lupus erythematosus (SLE) patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied....

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Published in:Reumatismo 2016-12, Vol.68 (3), p.137-143
Main Authors: Taraborelli, M, Lazzaroni, M G, Martinazzi, N, Fredi, M, Cavazzana, I, Franceschini, F, Tincani, A
Format: Article
Language:English
Subjects:
Antibodies, Anticardiolipin - blood
Antibodies, Antiphospholipid - blood
Anticoagulants - blood
antiphospholipid antibodies
antiphospholipid syndrome
Autoimmune diseases
beta 2-Glycoprotein I - blood
Biomarkers - blood
Clinical significance
Cohort Studies
Follow-Up Studies
Humans
Immunoglobulin G - blood
Immunoglobulin M - blood
Immunologic Factors - blood
Lupus
Lupus Erythematosus, Systemic - blood
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - immunology
Multivariate analysis
Predictive Value of Tests
Sensitivity and Specificity
Systemic lupus erythematosus
thrombosis
valvulopathy
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container_issue 3
container_start_page 137
container_title Reumatismo
container_volume 68
creator Taraborelli, M
Lazzaroni, M G
Martinazzi, N
Fredi, M
Cavazzana, I
Franceschini, F
Tincani, A
description The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL) in a cohort of systemic lupus erythematosus (SLE) patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM >99th percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney test for continuous variables) and multivariate analysis (logistic regression analysis). P values
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All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM &gt;99th percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney test for continuous variables) and multivariate analysis (logistic regression analysis). P values &lt;0.05 were considered significant. Among 317 SLE patients studied, 117 (37%) had a clinically significant aPL profile at baseline. Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS), but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA) when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR) 0.43] and ENA positivity (p&lt;0.001, OR 0.37), with increased risk of cardiac valvular disease (p=0.024, OR 3.1) and APS (p&lt;0.0001, OR 51.12). Triple positivity was the most frequent profile and was significantly associated to APS (p&lt;0.0001, OR 28.43). 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Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS), but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA) when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR) 0.43] and ENA positivity (p&lt;0.001, OR 0.37), with increased risk of cardiac valvular disease (p=0.024, OR 3.1) and APS (p&lt;0.0001, OR 51.12). Triple positivity was the most frequent profile and was significantly associated to APS (p&lt;0.0001, OR 28.43). 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subjects Antibodies, Anticardiolipin - blood
Antibodies, Antiphospholipid - blood
Anticoagulants - blood
antiphospholipid antibodies
antiphospholipid syndrome
Autoimmune diseases
beta 2-Glycoprotein I - blood
Biomarkers - blood
Clinical significance
Cohort Studies
Follow-Up Studies
Humans
Immunoglobulin G - blood
Immunoglobulin M - blood
Immunologic Factors - blood
Lupus
Lupus Erythematosus, Systemic - blood
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - immunology
Multivariate analysis
Predictive Value of Tests
Sensitivity and Specificity
Systemic lupus erythematosus
thrombosis
valvulopathy
title The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus
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