Non-criteria antiphospholipid antibody profiles and thrombotic outcomes in a cohort of patients with systemic lupus erythematosus.

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Lupus Science & Medicine Pub Date : 2024-12-12 DOI:10.1136/lupus-2024-001174

Alistair Murray, Eric J Campbell, Ann Elaine Clarke, Megan R W Barber, Tania Pannu, Marvin J Fritzler, Michelle Jung, Yvan St Pierre, Leslie Skeith

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引用次数: 0

Abstract

Objectives: Antiphospholipid syndrome (APS) is characterised by the presence of antiphospholipid antibodies (aPLs) and clinical outcomes of thrombosis and/or obstetric morbidity and is associated with systemic lupus erythematosus (SLE). IgG antiphosphatidylserine/prothrombin complex (aPS/PT), IgM aPS/PT and IgG anti-beta 2 glycoprotein 1-domain 1 (aβ2GP1-D1) are novel aPLs that have been associated with thrombosis; however, conclusive data are still lacking. It remains unclear how best to incorporate non-criteria autoantibodies into clinical decision-making. The aim of this study was to assess whether these novel aPLs were associated with an increased risk of thrombosis in patients with SLE.

Methods: We evaluated 341 patients enrolled in the SouThern Alberta Registry for Lupus EryThematosus database with SLE by the American College of Rheumatology or Systemic Lupus International Collaborating Clinics classification criteria. Medical records were reviewed between March 2006 and January 2021 for thrombotic events and serology results for lupus anticoagulant, IgG anticardiolipin, IgG anti-beta 2 glycoprotein 1 (aβ2GP1), IgG aPS/PT, IgM aPS/PT and IgG aβ2GP1-D1.

Results: Among 341 patients with SLE, 59 (17%) met the revised Sapporo lab criteria, and of those 29 (49%) had a major thrombotic event (OR 3.5, 95% CI 1.9 to 6.3). Among 142 patients who had at least one positive non-criteria autoantibody, 45 (32%) had a major thrombotic event (OR 1.6, 95% CI 0.97 to 2.6). In a univariate analysis, the IgG aPS/PT and IgG aβ2GP1-D1 were associated with major and all thrombotic events. In a multivariate analysis that controlled for age, sex, prednisone use, SLE disease activity (Systemic Lupus Erythematosus Disease Activity Index-2K and the revised Sapporo lab criteria, among the non-criteria aPLs, only IgG aPS/PT was associated with an increased risk of a major thrombosis (OR 2.2, 95% CI 1.1 to 4.5).

Conclusions: In our multivariate analysis, IgG aPS/PT was associated with a modestly increased risk of thrombotic events.

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系统性红斑狼疮患者队列中的非标准抗磷脂抗体概况与血栓形成结果。

目的：抗磷脂综合征（APS）以抗磷脂抗体（APS）的存在和血栓形成和/或产科发病率的临床结果为特征，并与系统性红斑狼疮（SLE）相关。IgG抗磷脂酰丝氨酸/凝血酶原复合物（aPS/PT）、IgM aPS/PT和IgG抗β2糖蛋白1结构域1 （a - β 2gp1 - d1）是与血栓形成相关的新型apl；然而，仍然缺乏结论性的数据。目前尚不清楚如何最好地将非标准自身抗体纳入临床决策。本研究的目的是评估这些新型apl是否与SLE患者血栓形成风险增加有关。方法：根据美国风湿病学会或系统性狼疮国际合作诊所的分类标准，我们评估了341名在南艾伯塔省红斑狼疮数据库登记的红斑狼疮患者。回顾了2006年3月至2021年1月期间的医疗记录，以了解血栓形成事件和狼疮抗凝血剂、IgG抗心磷脂、IgG抗β2糖蛋白1 （aβ2GP1）、IgG aPS/PT、IgM aPS/PT和IgG aβ2GP1- d1的血清学结果。结果：在341例SLE患者中，59例（17%）符合修订后的Sapporo实验室标准，其中29例（49%）有主要血栓形成事件（OR 3.5, 95% CI 1.9至6.3）。在142例至少有一种非标准自身抗体阳性的患者中，45例（32%）有重大血栓形成事件（OR 1.6, 95% CI 0.97至2.6）。在单变量分析中，IgG aPS/PT和IgG aβ 2gp1 - d1与主要和所有血栓形成事件相关。在一项控制年龄、性别、强的松使用、SLE疾病活动性（系统性红斑狼疮疾病活动性指数- 2k和修订的Sapporo实验室标准）的多变量分析中，在非标准apl中，只有IgG aPS/PT与主要血栓形成风险增加相关（OR 2.2, 95% CI 1.1至4.5）。结论：在我们的多变量分析中，IgG aPS/PT与血栓事件风险适度增加相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lupus Science & Medicine RHEUMATOLOGY-

CiteScore

5.30

自引率

7.70%

发文量

审稿时长

15 weeks

期刊介绍： Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.