ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2553

The Clinical Value Of Testing For Aphl, a New ELISA Kit With a Unique Phospholipid Mixture In Patients With Systemic Lupus Erythematosus (SLE)

Savino Sciascia1, Giovanni Sanna2, Veronica Murru3, Munther A. Khamashta4 and Maria Laura Bertolaccini3, 1Department of Rare, Immunologic, Hematologic and Immunohematologic Diseases, Centro di Immunopatologia e Documentazione su Malattie rare, Torino, Italy, 2Louise Coote Lupus Unit, St. Thomas' Hospital, London, United Kingdom, 3Lupus Research Unit, The Rayne Institute, Kings College London School of Medicine, London, United Kingdom, 4Lupus Research Unit, The Rayne Institute, St Thomas Hospital, Kings College London School of Medicine, London, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Systemic Lupus Erythematosus-Clinical Aspects III: Biomarkers, Quality of Life and Disease Indicators, Late Complications

Session Type: Abstract Submissions (ACR)

Background/Purpose:  Antibodies directed to APhL (a mixture of phospholipids) have been reported to predict APS more reliably than aCL tests. We designed this study to evaluate the performance characteristics of the IgG and IgM APhL ELISA, in an attempt to establish the diagnostic utility of these new aPL antibody tests in a wide cohort of SLE patients.

Methods: This study included 158 patients (152 women, mean age 41.8±11.6 years, mean disease duration 11.7±7.8years), all fulfilling the 1982 criteria for SLE. All the patients were tested for the routinely used aPL, including LA, aCL and ab2GPI. Data were compared with that obtained by the APhL ELISA (Louisville APL Diagnostic, Inc, Louisville, KY, USA).  The diagnostic accuracy for each test was assessed by ROC and their area under the curve (AUC) analysis.

Results: APhL were found in 77% of the patients. IgG and IgM APhL were more frequently found along with routine aPL than in isolation (p=0.007 and p=0.04, respectively). APhL were more frequently found in patients with definite APS than in those without (p=0.001). aPhL were not only more frequent in patients with thrombosis than in those without (p=0.02) but their titres were also significantly higher in thrombosis, when compared to those without (p=0.02). APhL showed an OR for thrombosis of 1.46 [95%CI1.08-3.19] (AUC 0.533). Twenty-seven patients (17.09%) were positive for isolated APhL. Of those 8 (29.6%) had a thrombotic event (6 arterial, 1 venous, 1 both). No associations were found between the presence of APhL and pregnancy loss. The presence of aPhL did not correlate with that of any of the other aPL tested. Multivariate analysis confirmed the associations with APS, particularly with thrombosis.

Conclusion: APhL are frequent in patients with SLE. Their presence is associated with thrombosis, making these antibodies a novel marker for APS.  The finding of isolated APhL in thrombosis (particularly arterial) deserves further investigation.

Disclosure:

S. Sciascia,
None;

G. Sanna,
None;

V. Murru,
None;

M. A. Khamashta,
None;

M. L. Bertolaccini,
None.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-clinical-value-of-testing-for-aphl-a-new-elisa-kit-with-a-unique-phospholipid-mixture-in-patients-with-systemic-lupus-erythematosus-sle/