Prospective Validation of the Global Antiphospholipid Syndrome Score (GAPSS)

Background/Purpose: Backgrounds: This study was performed to prospectively and independently validate the GAPSS (1) (Global APS Score), a score system  derived from the combination of independent risk factors for thrombosis, taking into account the antiphospholipid antibodies (aPL) profile and  the conventional cardiovascular risk factors.

Methods:

GAPSS were prospectively applied to 52 consecutive SLE patients with positive aPL (51 female, mean age 39.1±10.6, mean follow-up 47.53±19.15 months). GAPSS scoring system was calculated yearly for each patient by adding together the points corresponding to the risk factors.

Results:

 An increase in the GAPSS (entry Vs. last visit) was seen in patients who experienced thrombosis (n=5, 6±5.05 Vs 9.4±4.93, p=0.0388). No changes were observed in those without thrombotic event (n=47, 8.28±4.88 Vs 7.13±5.75, p= NS).

An increase of more than 3 points in GAPSS during the follow-up was strongly associated with higher risk of thrombosis (HR 25.00 [95%IC 3.74-189.1]). The risk of thrombosis was also evaluated by Kaplan-Meier analysis (fig.1; IE: ischemic event) and the cumulative proportion of thrombosis-free individuals was higher (p=0.002) in the patients whose GAPSS was not increased by 3 or more points. 

Conclusion:

 We have prospectively demonstrated that GAPSS is a valid tool for accurate prediction of thrombosis in SLE patients with aPL.  

1. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology (Oxford). 2013 Jan 12. [Epub ahead of print]