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Abstract Number: 1735

Independent Validation of the Antiphospholipid Score (aPL-S) for the Diagnosis of Antiphospholipid Syndrome (APS)

Savino Sciascia1, Maria Laura Bertolaccini1, Dario Roccatello2 and Munther A. Khamashta3, 1Lupus Research Unit, The Rayne Institute, Kings College London School of Medicine, London, United Kingdom, 2Department of Rare, Immunologic, Hematologic and Immunohematologic Diseases, Centro di Immunopatologia e Documentazione su Malattie rare, Torino, Italy, 3Lupus Research Unit, The Rayne Institute, St Thomas Hospital, Kings College London School of Medicine, London, United Kingdom

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: antiphospholipid syndrome, pregnancy, risk assessment and thrombosis

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Session Information

Session Title: Antiphospholipid Syndrome

Session Type: Abstract Submissions (ACR)

Background/Purpose: The so called “antiphospholipid score (aPL-S)” was recently developed and validated (1). This score was shown to be a useful quantitative index for diagnosing APS and to be valuable as a predictive marker for thrombosis in autoimmune diseases. We aimed to independently validate the aPL-S by applying the proposed score system to our cohort of SLE patients. (1. Otomo et al. Arthritis Rheum 2012; 64: 504)

Methods: we applied the aPL-S to a cohort of 211 consecutive SLE patients, all attending our Lupus Clinic. aPL-S was calculated for each patient by adding together the points corresponding to the risk factors as described. To validate the aPL-S, we adapted the proposed score using our in house cut-off values for aPL testing as previously reported or according to the current guidelines, as appropriate.  

Results: Overall, 81 patients fulfilled criteria for APS and 73 patients had a history of thrombosis (48 arterial, 41 venous). Out of 144 women who had ever been pregnant, 61 had a history of pregnancy loss. Higher values of aPL-S were seen in patients who experienced thrombosis and/or pregnancy loss when compared to those without clinical events (median 17 [0-86] vs. 4 [0-31], p<0.001).  When analysing clinical subgroups, patients who experienced thrombosis or pregnancy loss showed higher aPL-S compared to those without clinical events (median 18 [0-86] vs. 4 [0-27], p<0.001 for thrombosis; 7 [0-69] vs. 3 [0-29], p=0.029 for pregnancy loss). When the cut-off level for the aPL-S was defined as 30, as per the original study (1) the sensitivity and specificity of the aPL-S were 39% and 95%. The PPV of an aPL-S ≥30 was 36%, whereas the NPV was 91%.

Conclusion: We demonstrated that the aPL profile can be successfully quantified by the aPL-S in an independent cohort of SLE patients. The aPL-S correlated with a history of thrombosis and pregnancy loss in our cohort, suggesting that the aPL-S is a suitable quantitative marker for APS.


Disclosure:

S. Sciascia,
None;

M. L. Bertolaccini,
None;

D. Roccatello,
None;

M. A. Khamashta,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/independent-validation-of-the-antiphospholipid-score-apl-s-for-the-diagnosis-of-antiphospholipid-syndrome-aps/

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