Session Type: Abstract Submissions (ACR)
Background/Purpose: Antiphospholipid Syndrome (APS) is a heterogeneous entity with a wide variation in clinical course and laboratory profile. We aimed to evaluate the clinical utility of GAPSS (Global APS Score) in a cohort of primary APS patients. GAPSS is derived from the combination of independent risk for thrombosis and pregnancy loss (PL), taking into account the antiphospholipid antibodies (aPL) profile, the conventional cardiovascular risk factors, and the autoimmune antibodies profile.
Methods: This study included 62 consecutive with primary APS. Data on clinical manifestations, conventional cardiovascular risk factors, and antiphospholipid antibodies profile were collected. GAPSS scoring system was calculated for each patient by adding together the points corresponding to the risk factors, based on a linear transformation of the corresponding β regression coefficient as follows: 3 for hyperlipidemia, 1 for arterial hypertension, 5 for aCL IgG/IgM, 4 for anti-2GPI IgG/IgM, 3 for aPS/PT IgG/IgM and 4 for LA.
Results: Higher values of GAPSS were showed in patients who experienced thrombosis alone compared to those with pregnancy loss (PL) alone (11.5±4.6 and 8.7±3.2,p=0.0378). Patients with both thrombosis and pregnancy loss showed higher GAPSS compared to those pregnancy loss alone (12.5±4.6 vs 8.7±3.2,p=0.0152).Higher values were also shown sub-grouping for the site of thrombosis, compared to pregnancy loss alone (12.2±5.2, for arterial thrombosis; 12.±4.0 for venous and 8.7±3.2, p=0.0214 and p=0.0472, respectively). Patients with thrombotic recurrences showed higher values of GAPSS compared to those without (13.7±3.1Vs 9.4±3.9,p=0.0205, respectively). Higher values were also seen when comparing recurrences Vs no recurrences according to the site of thrombotic event (13.9±3.6 and 11.0±4.3,p=0.0143 for arterial; 13.6±2.18 Vs 8.91±3.6,p=0.001, for venous events, respectively).
GAPSS values higher or equal to 11 were strongly associated with higher risk of recurrences (OR 18.27 [95%IC 3.74-114.5] for cut off 11, OR 20.64[3.92-185.92] for cut off 12, 21.64[3.89-189.56] for cut off 15, respectively. GAPSS values higher or equal to 11 seemed to have the best accuracy, in terms of sensitivity and specificity.
Conclusion: GAPSS is demonstrated to be a valid tool to a substantial improvement in risk stratification for thrombosis in primary APS, also in terms of recurrences.
M. A. Khamashta,
M. L. Bertolaccini,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-global-antiphospholipid-syndrome-score-gapss-in-primary-aps/