Anti-RNP/Sm Antibodies Plus Lupus Anticoagulant As Risk Factor for Thrombosis in Patients with Systemic Lupus Erythematosus

Mari Carmen Zamora-Medina¹, Andrea Hinojosa-Azaola², Carlos Núñez-Álvarez³ and Juanita Romero-Diaz⁴, ¹Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutricion S.Z., Mexico City, Mexico, ²Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, ³Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion S.Z., Mexico city, Mexico, ⁴Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico city, Mexico

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: risk assessment and thrombosis, SLE

Session Information

Date: Sunday, November 5, 2017

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: In a previous study, we identify a potential role of anti-RNP/Sm in combination with LA as risk factor for thrombosis. We aimed to validate this association

Methods: Case-control study of patients with SLE who presented thrombosis after SLE diagnosis and controls with SLE without thrombosis. All patients fulfilled ³ 4 American College of Rheumatology revised and updated classification criteria for SLE. Comorbidities, traditional risk factors, clinical variables, disease activity and treatment were evaluated. Also, a blood sample was drawn to determine antiphospholipid (aPL) and anti-RNP/Sm antibodies. Statistical analysis: Differences between groups were evaluated with the Student t-test or Mann-Whitney U test for continuous variables; Chi-square or Fisher’s exact test for categorical variables. Univariate logistic regression analyses and multivariate analyses were performed. Odds-ratio (OR) and 95% confidence intervals (95% CI) were calculated

Results: 63 cases and 63 controls were studied, 88% women, median age of 40 years and disease duration of 135 months at study inclusion. No differences were found between groups regarding age, comorbidities, or clinical characteristics at SLE diagnosis. Patients with thrombosis were more frequently positive for anti-RNP/Sm (83% vs 62%, p=0.001); IgG aCL (29% vs 11%, p=0.02); IgG anti-B2GPI (21% vs 13%, p=0.02); IgM anti-B2GPI (p=0.02); LA (62% vs 19%, p<0.001); the combination of anti-RNP/Sm + LA (52% vs 14%, p<0.001), and aPL triple marker (17% vs 2%, p=0.002), compared to controls. The combination of anti-RNP/Sm + LA (OR 5.98, 95% CI 2.17-16.47, p=0.001); SLEDAI-2K (OR 1.18, 95% CI 1.04-1.32, p=0.007), and prednisone dose (OR 1.08, 95% CI 1.03-1.12, p<0.001) were independently associated with thrombosis.

Conclusion: This study confirmed an independent association between the combination of anti-RNP/Sm antibodies and LA with thrombosis. Further studies to identify potential pathogenesis mechanisms of the presence of anti-RNP/Sm and thrombosis are needed

Disclosure: M. C. Zamora-Medina, None; A. Hinojosa-Azaola, None; C. Núñez-Álvarez, None; J. Romero-Diaz, None.

To cite this abstract in AMA style:

Zamora-Medina MC, Hinojosa-Azaola A, Núñez-Álvarez C, Romero-Diaz J. Anti-RNP/Sm Antibodies Plus Lupus Anticoagulant As Risk Factor for Thrombosis in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/anti-rnpsm-antibodies-plus-lupus-anticoagulant-as-risk-factor-for-thrombosis-in-patients-with-systemic-lupus-erythematosus/. Accessed .

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