Background/Purpose: Our objectives were 1- to perform an external validation of the Global Anti-Phospholipid Syndrome Score (GAPSS) and 2- to compare prognostic significances of GAPPS and a novel assays IgG antibodies directed against domain I of ß2-glycoprotein I (antiDI) in patients with antiphospholipid antibodies (aPL) and/or systemic lupus erythematosus (SLE).
Methods: We performed a prospective cohort study in French University Hospitals. Consecutive patients with aPL and/or SLE according to ACR classification without ongoing anticoagulant treatment were enrolled. The outcome was the time to the first incident thrombotic event. Blood was drawn at baseline. ELISA antiDI and anti-phosphatidyl/prothrombin antibodies assays were performed together with traditional assays (lupus anticoagulant, anticardiolipin and anti-ß2-glycoprotein I antibodies). GAPSS was computed for each patient.
Results: One hundred and thirty eight patients (median age 43.5±15.3 years; 108 women) were followed-up for a mean duration of 43±20.7 months (493.9 patient-years). Thrombosis during follow-up occurred in 16 patients (3 strokes, 1 myocardial infarction, 1 splanchnic arterial thrombosis, 3 pulmonary embolisms, 3 deep vein, 5 small vessels thromboses). Higher values of GAPSS were seen in patients who experienced thrombosis compared to those without (10.9±4.8 vs 7.9±5.4, p=0.03). While triple positivity (HR=2.38 [CI95%; 0.83-6.80], p=0.11) and GAPSS above 10 (HR=1.56 [CI95%; 0.55-4.47], p=0.41) were not predictive of further incident thrombotic events, GAPSS above 16 (HR=5.27 [CI95%; 1.16-23.93], p=0.03) and high levels of antiDI above the 90th percentile of patients (HR=5.64 [CI95%; 1.94-16.42], p=0.002) were highly predictive of incident thrombotic events.
Conclusion: GAPSS and high levels of antiDI are significant predictors of thrombosis in aPL/SLE patients. These antibodies seem to add a substantial improvement in risk prediction of thrombosis independently of clinical variables assessed by GAPSS’ components.
Disclosure:
S. Zuily,
None;
B. De Laat,
None;
V. Regnault,
None;
P. Kaminsky,
SHIRE HGT,
6,
Genzyme Corporation,
6;
H. Kelchtermans,
None;
Z. Shums,
Inova Diagnostics, Inc.,
3;
R. Albesa,
Inova Diagnostics, Inc.,
3;
G. L. Norman,
Inova Diagnostics, Inc.,
3;
P. de Groot,
None;
A. C. Rat,
None;
J. Ninet,
None;
N. Magy-Bertrand,
None;
J. L. Pasquali,
None;
M. Lambert,
None;
B. Lorcerie,
None;
T. Lecompte,
None;
F. Guillemin,
None;
D. Wahl,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/external-validation-of-the-global-anti-phospholipid-syndrome-score-in-comparison-to-igg-antibodies-directed-against-domain-i-of-s2-glycoprotein-i-a-prospective-multicentre-cohort-study/