The presence of non-criteria manifestations negatively affects the prognosis of seronegative antiphospholipid syndrome patients: a multicenter study.

Abstract

BACKGROUND:

Seronegative antiphospholipid syndrome (SN-APS) is often defined as the presence of APS criteria manifestations, negative antiphospholipid antibodies (aPL), and coexistence of APS non-criteria manifestations. Nevertheless, the impact of these non-criteria features is still unclear. On a different note, the relevance of one single aPL positive determination in patients with APS manifestations is another domain with limited evidence. We aim to compare the course of SN-APS and single-positive aPL (SP-aPL) patients with that of individuals with APS manifestations without non-criteria features/aPL positivity (controls).

METHODS:

Retrospective analysis of patients with thrombosis/obstetric morbidity assessed in two European hospitals between 2005 and 2020. Patients were divided into SN-APS, SP-aPL, and control groups. Clinical characteristics, comorbidities, and therapies were compared.

RESULTS:

A total of 82 patients were included in the SN-APS group, 88 in the SP-aPL group, and 185 in the control group. In Cox regression model, SN-APS displayed more thrombosis recurrence than controls (HR 3.8, 95% CI 2.2-6.5, p < 0.001) even when adjusting for the presence of hereditary thrombophilia, systemic lupus erythematosus, or contraceptive hormonal treatment. In SP-aPL, the difference in thrombosis recurrence did not reach statistical significance (p = 0.078). Indefinite anticoagulation (p < 0.001 and p = 0.008, respectively) and vitamin K antagonist (VKA) use (p < 0.001 in both cases) were more common in SN-APS/SP-aPL.

CONCLUSION:

SN-APS displayed more thrombosis recurrence, indefinite anticoagulation, and VKA use than controls without non-criteria manifestations. The presence of such features in patients with thrombosis and negative aPL may negatively impact their clinical course.

• Authors: Gilberto Pires da Rosa, Bernardo Sousa-Pinto, Ester Ferreira, Olga Araújo, Giuseppe Barilaro, Paulo Bettencourt, Ricard Cervera, Gerard Espinosa
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 24 Issue 1 Pg. 9 (01 03 2022) ISSN: 1478-6362 [Electronic] England
• PMID: 34980238 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s).

Chemical References

• Antibodies, Antiphospholipid

Topics

• Antibodies, Antiphospholipid
• Antiphospholipid Syndrome (complications, diagnosis)
• Female
• Humans
• Lupus Erythematosus, Systemic (complications, drug therapy)
• Pregnancy
• Prognosis
• Retrospective Studies