ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0115

Regional and Ethnoracial Differences Among Antiphospholipid Antibody-Positive Patients with No Other Systemic Autoimmune Rheumatic Diseases: Results from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Registry

Elena Gkrouzman1, Ann E. Clarke2, Maria Tektonidou3, Vittorio Pengo4, Savino Sciascia5, Jose Pardos-Gea6, Nina Kello7, Diana Paredes-Ruiz8, Mª Angeles Aguirre-Zamorano9, H Michael Belmont10, Paul Fortin11, Guilherme Ramires de Jesús12, Tatsuya Atsumi13, Zhuoli Zhang14, Maria Efthymiou15, David Branch16, Giulia Pazzola17, Laura Andreoli18, Ali Duarte-Garcia19, Esther Rodriguez-Almaraz20, Michelle Petri21, Ricard Cervera22, Bahar Artim Esen23, Guillermo Pons-Estel24, Hui Shi25, Jason Knight26, Rohan Willis27, Pierluigi Meroni28, Maria Laura Bertolaccini29, Hannah Cohen30, Robert Roubey31, Danieli Andrade32 and Doruk Erkan33, and on behalf of APS ACTION, 1University of Massachusetts, Westborough, MA, 2Division of Rheumatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 3National and Kapodistrian University of Athens, Athens, Greece, 4Thrombosis Research Laboratory, Department of Cardio-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy, 5University of Turin, Torino, Turin, Italy, 6Vall d'Hebron University Hospital, Barcelona, Spain, 7Northwell Health, Brooklyn, NY, 8Autoimmune Diseases Research Unit. Biocruces Bizkaia Health Research Institute, Baracaldo, Spain, 9IMIBIC/Reina Sofia Hospital/University of Cordoba, CÓRDOBA, Andalucia, Spain, 10NYU School of Medicine, New York, NY, 11Centre ARThrite - CHU de Québec - Université Laval, Quebec, QC, Canada, 12Universidade do Estado do Rio de Janeiro, Rio De Janeiro, Brazil, 13Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan, Sapporo, Japan, 14Peking University First Hospital, Beijing, China, 15University College London, London, United Kingdom, 16University of Utah and Intermountain Healthcare, Salt Lake City, UT, 17Rheumatology Unit, Azienda USL IRCCS di Reggio Emilia, Reggio Emilia, Italy, 18University of Brescia, Brescia, Italy, 19Mayo Clinic, Rochester, MN, 20Hospital Universitario 12 de Octubre, Madrid, Spain, 21Johns Hopkins University School of Medicine, Timonium, MD, 22Hospital Clinic de Barcelona, Barcelona, Spain, 23Istanbul University, Istanbul Faculty of Medicine, Division of Rheumatology, Istanbul, Turkey, 24CREAR, Rosario, Argentina, 25Department of Rheumatology and lmmunology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, Shanghai, China (People's Republic), 26University of Michigan, Ann Arbor, MI, 27University of Texas Medical Branch, Galveston, TX, 28IRCCS Istituto Auxologico Italiano 100%, Cusano Milanino, Milan, Milan, Italy, 29King's College London, London, United Kingdom, 30University College London Hospitals NHS Foundation Trust, London, United Kingdom, 31Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill, NC, 32University of São Paulo, São Paulo, SP, Brazil, 33Hospital for Special Surgery, New York, NY

Meeting: ACR Convergence 2024

Keywords: ,

Session Information

Date: Saturday, November 16, 2024

Title: Antiphospholipid Syndrome Poster

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: The APS ACTION Registry was created to study long-term outcomes in persistently antiphospholipid antibody (aPL)-positive patients with and without other systemic autoimmune rheumatic diseases (SARDs). Our goal was to examine the regional and ethnoracial differences in clinical phenotypes and aPL profiles among aPL-positive patients with no other SARDs.

Methods: A web-based data capture system is used to store patient demographics and aPL-related medical history. Inclusion criteria are positive aPL, based on the Revised Sapporo APS classification criteria, tested at least twice within one year prior to enrollment. Patients are followed every 12±3 months with clinical data and blood collection. For this cross-sectional analysis of the baseline data, demographic, clinical, and laboratory characteristics of registry patients were analysed based on different regions (Europe [EU], North America [NA], Latin America [LA], and Asia-Pacific [AP]) and self-reported ethnorace (White, Latin American Mestizo [LAM], Asian, and Black) using chi square, Fisher’s exact, and Kruskal-Wallis tests.

Results: As of December 2023, 61% (728/1,204) of the registry patients had no history of other SAID, while 78% (568/728) fulfilled the Revised Sapporo APS classification criteria (365 [50%] from EU, 204 [28%] NA, 115 [16%] LA, and 44 [6%] AP) (516 [78%] White, 82 [12%] LAM, 49 [7%] Asian, and 13 [2%] Black). Based on regional comparisons: a) overall macrovascular thrombosis and venous thrombosis, microvascular disease, and cardiac valve disease were more frequent in patients from LA, NA, and AP, respectively; b) thrombocytopenia in NA and AP; c) livedo reticularis/racemosa in LA; and d) triple aPL-positivity in NA and EU with isolated lupus anticoagulant positivity in LA (Table 1). Based on ethnoracial comparisons:  a) there were less females among White patients; b) cardiac valve disease was more frequent in Asians, and livedo reticularis/racemosa in LAM; and c) triple aPL positivity was more frequent in Whites, while isolated lupus anticoagulant positivity in LAM patients (Table 2).

Conclusion: In the APS ACTION international registry of patients with persistently aPL-positive patients with or without APS classification, Blacks were the least frequently (2%) represented ethnoracial group. This finding aligns with other studies suggesting that APS is relatively rare in Black individuals. However, it is important to acknowledge the potential for inherent selection biases and disparities in healthcare access that may influence these results. Our analysis highlights the need for further investigation into the genetic and social determinants impacting the clinical and serologic phenotype of aPL-positive patients across diverse populations.

Supporting image 1

Table 1: Clinical and Laboratory Characteristics of Antiphospholipid Antibody-Positive Patients with No Other Systemic Autoimmune Diseases by Region

Supporting image 2

Table 2: Clinical and Laboratory Characteristics of Antiphospholipid Antibody-Positive Patients with No Other Systemic Autoimmune Diseases by Ethnoracial Group

Disclosures: E. Gkrouzman: None; A. Clarke: AstraZeneca, 2, 5, 6, Bristol Myers Squibb, 2, GSK, 2, 5, 6, Otsuka Pharmaceutical, 1, Roche, 1; M. Tektonidou: None; V. Pengo: None; S. Sciascia: Chugai Pharmaceutical Co., Ltd., 2; J. Pardos-Gea: None; N. Kello: None; D. Paredes-Ruiz: None; M. Aguirre-Zamorano: None; H. Belmont: Alexion, 1, Aurinia, 6; P. Fortin: AstraZeneca, 2, 6, GlaxoSmithKlein(GSK), 2, 6, Moderna, 2; G. Ramires de Jesús: None; T. Atsumi: AbbVie, 6, Alexion Inc., 6, Asahi-Kasei Co., 6, Astellas Pharma Inc., 6, AstraZeneca, 2, 6, Bayer Yakuhin, 6, Bristol-Myers Squibb(BMS), 6, Chugai Pharmaceutical Co., Ltd., 6, Daiichi Sankyo Co., Ltd., 6, Eisai Co. Ltd., 6, Eli Lilly Japan K.K., 6, Gilead Sciences K.K., 6, GSK, 2, 5, Janssen, 6, Mitsubishi Tanabe Pharma Co., 6, Nippon Boehringer Ingelheim Co., Ltd., 2, 6, Nippon Shinyaku Co., Ltd., 6, Novartis, 2, 6, Otsuka, 2, Pfizer, 6, Taiho Pharmaceutical Co. Ltd., 6, UCB, 6; Z. Zhang: None; M. Efthymiou: None; D. Branch: UCB Pharma Inc, 5; G. Pazzola: None; L. Andreoli: Pfizer, 2, UCB, 2; A. Duarte-Garcia: None; E. Rodriguez-Almaraz: None; M. Petri: Amgen, 2, AnaptysBio, 2, Annexon Bio, 2, Arthros-FocusMedEd, 6, AstraZeneca, 2, 5, Atara Biosciences, 2, Aurinia, 5, 6, Autolus, 2, Avoro Ventures, 2, Biocryst, 2, Boxer Capital, 2, Cabaletto Bio, 2, Caribou Biosciences, 2, CTI, 1, CVS Health, 1, Eli Lilly, 2, 5, Emergent Biosolutions, 1, Ermiium, 2, Escient Pharmaceuticals, 2, Exagen, 5, Exo Therapeutics, 2, Gentibio, 2, GlaxoSmithKlein(GSK), 2, 5, iCell Gene Therapeutics, 2, Innovaderm Research, 2, IQVIA, 1, Janssen, 5, Kira Pharmaceuticals, 2, Merck/EMD Serono, 1, Nexstone Immunology, 2, Nimbus Lakshmi, 2, Novartis, 2, PPD Development, 2, Precision Biosciences, 2, Proviant, 2, Regeneron Pharmaceuticals, 2, Sanofi, 2, Seismic Therapeutic, 2, Senti Bioscienes, 2, Sinomab Biosciences, 2, Takeda, 2, Tenet Medicines Inc, 2, TG Therapeutics, 2, UCB, 2, Vertex Pharmaceuticals, 2, Worldwide Clinical Trials, 1, Zydus, 2; R. Cervera: None; B. Artim Esen: None; G. Pons-Estel: AbbVie/Abbott, 1, AstraZeneca, 1, 6, Boehringer-Ingelheim, 6, GlaxoSmithKlein(GSK), 1, 5, 6, Janssen, 1, 5, 6, Werfen/Inova, 6; H. Shi: None; J. Knight: ArgenX, 1, Visterra/Otsuka, 1, 2; R. Willis: Louisville APL Diagnostics Inc, 2, 8; P. Meroni: None; M. Bertolaccini: None; H. Cohen: argenx, 1, GlaxoSmithKlein(GSK), 6, Roche, 1, Technoclone (paid to Univ Coll London Hosp Charity), 6, UCB (paid to Univ College London Hosp Charity), 2; R. Roubey: None; D. Andrade: None; D. Erkan: ACR, 5, APS ACTION, 4, Argenx, 1, Cadrenal, 2, Chugai, 1, EULAR, 5, Exagen, 5, GlaxoSmithKlein(GSK), 2, 5, 6, Kyverna, 1, NIH, 5, Otsuka/Visterra, 1, Up-To-Date, 9.

To cite this abstract in AMA style:

Gkrouzman E, Clarke A, Tektonidou M, Pengo V, Sciascia S, Pardos-Gea J, Kello N, Paredes-Ruiz D, Aguirre-Zamorano M, Belmont H, Fortin P, Ramires de Jesús G, Atsumi T, Zhang Z, Efthymiou M, Branch D, Pazzola G, Andreoli L, Duarte-Garcia A, Rodriguez-Almaraz E, Petri M, Cervera R, Artim Esen B, Pons-Estel G, Shi H, Knight J, Willis R, Meroni P, Bertolaccini M, Cohen H, Roubey R, Andrade D, Erkan D. Regional and Ethnoracial Differences Among Antiphospholipid Antibody-Positive Patients with No Other Systemic Autoimmune Rheumatic Diseases: Results from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Registry [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/regional-and-ethnoracial-differences-among-antiphospholipid-antibody-positive-patients-with-no-other-systemic-autoimmune-rheumatic-diseases-results-from-antiphospholipid-syndrome-alliance-for-clinica/. Accessed .

« Back to ACR Convergence 2024

ACR Meeting Abstracts - https://acrabstracts.org/abstract/regional-and-ethnoracial-differences-among-antiphospholipid-antibody-positive-patients-with-no-other-systemic-autoimmune-rheumatic-diseases-results-from-antiphospholipid-syndrome-alliance-for-clinica/