ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2654

IgG Antibodies Directed Against Domain I Of ß2-Glycoprotein I Are Significant Predictors Of Thromboembolic Events In Patients With Antiphospholipid Antibodies. A Prospective Cohort Study

Stephane Zuily1, Bas de Laat2, Francis Guillemin3, Pierre Kaminsky4, Hilde Kelchtermans5, Roger Albesa6, Gary L. Norman6, Anne-Christine Rat7, Philip de Groot8, Thomas Lecompte9, Veronique Regnault10 and Denis Wahl1, 1CHU de Nancy, Vascular Medicine Division and Regional Competence Center For Rare Vascular And Systemic Autoimmune Diseases, Nancy, F-54000, France; Inserm, UMR_S 1116, Nancy, F-54000, France; Université de Lorraine, Nancy, F-54000, France, Nancy, France, 2Biochemistry, CARIM, Maastricht University, The Netherlands; Clinical Chemistry and Hematology, UMC Utrecht, The Netherlands; Synapse BV, Maastricht, The Netherlands; Sanquin Research, Amsterdam, The Netherlands, Maastricht, Netherlands, 3CHU Nancy, Clinical Epidemiology and Evaluation, Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France, 4Université de Lorraine, Nancy, F-54000, France; CHU de Nancy, Orphan disease unit, Nancy, F-54000, France;, Nancy, France, 5Biochemistry, CARIM, Maastricht University, The Netherlands; Synapse BV, Maastricht, The Netherlands, Maastricht, Netherlands, 6Research, INOVA Diagnostics, San Diego, CA, 7Université de Lorraine, Nancy, F-54000, France; Inserm, CIC-EC CIE6, Nancy, F-54000, France; CHU de Nancy, Clinical Epidemiology and Evaluation Department, Nancy, F-54000, France; CHU de Nancy, Rheumatology department, Nancy, France, 8Clinical Chemistry and Hematology, UMC Utrecht, The Netherlands, Utrecht, Netherlands, 9Inserm, UMR_S 1116, Nancy, F-54000, France; Université de Lorraine, Nancy, F-54000, France; CHU de Nancy, Haematology Laboratory, Nancy, F-54000, France; Division of Haematology, HUG, Geneva, Switzerland (current address), Geneva, Switzerland, 10Inserm, UMR_S 1116, Nancy, F-54000, France; Université de Lorraine, Nancy, F-54000, France; CHU de Nancy, Contrat d’interface, Nancy, F-54000, France, Nancy, France

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Antiphospholipid Syndrome

Session Type: Abstract Submissions (ACR)

Abstract

Background/Purpose : Our objective was to prospectively determine the prognostic significance of laboratory variables regarding thrombotic events during follow-up, including novel assays IgG antibodies directed against domain I of ß2-glycoprotein I (antiDI) and IgG anti-phosphatidylserine–prothrombine (antiPS-PT) antibodies in patients with systemic lupus erythematosus (SLE) and/or antiphospholipid antibodies (aPL).

Methods : We performed a prospective cohort study in a French University Hospital and tertiary care center. Consecutive patients with SLE and/or aPL 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 antiPS-PT antibodies assays were performed together with traditional assays (lupus anticoagulant, anticardiolipin and anti-ß2-glycoprotein I antibodies).

Results : Ninety-two patients (median age 40 years [interquartile range IQR: 29-58]; 74 women) were followed-up for a median duration of 35 months (IQR: 26-62; 320 patient-years). Thrombosis during follow-up occurred in 11 patients (2 strokes, 1 myocardial infarction, 1 splanchnic arterial thrombosis, 2 pulmonary embolisms, 2 deep vein thromboses, 3 small vessels thromboses). Triple positivity, high levels of antiDI and of antiPS-PT antibodies were found in 17, 10 and 13 patients respectively. In univariate analysis, high levels of antiDI (HR=6.41 [CI95%; 1.72-23.89], p=0.006) and antiPS-PT antibodies (HR=3.62 [CI95%, 1.06-12.37], p=0.04) were significantly predictive of incident thrombotic event while triple positivity did not reach statistical significance (HR=3.09 [CI95%; 0.90-10.66], p=0.07). In multivariate analysis (stepwise method), high levels of antiDI antibodies remained the only laboratory variable significantly predictive of incident thrombotic events overtime.

Conclusion : High levels of IgG antibodies directed against the domain I of the ß2-glycoprotein I are significant predictors of thrombosis in patients with aPL and/or SLE.

Disclosure:

S. Zuily,
None;

B. de Laat,
None;

F. Guillemin,
None;

P. Kaminsky,
None;

H. Kelchtermans,
None;

R. Albesa,

Inova Diagnostics, Inc.,

3;

G. L. Norman,

Inova Diagnostics, Inc.,

3;

A. C. Rat,
None;

P. de Groot,
None;

T. Lecompte,
None;

V. Regnault,
None;

D. Wahl,
None.

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