Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients
OBJECTIVES: To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. METHODS: In 1999, we started an observational study of 1000 APS pat...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2014 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositório: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/119677 |
| Acesso em linha: | https://hdl.handle.net/2445/119677 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Síndrome antifosfolipídica Lupus eritematós Malalties autoimmunitàries Morbiditat Estudi de casos Antiphospholipid syndrome Lupus erythematosus Autoimmune diseases Morbidity Case studies |
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Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patientsCervera i Segura, Ricard, 1960-Serrano, R.Pons-Estel, G. J.Ceberio-Hualde, L.Shoenfeld, Yehudade Ramón, EnriqueBuonaiuto, V.Jacobsen, SørenZeher, M. M.Tarr, T.Tincani, AngelaTaglietti, M.Theodossiades, G.Nomikou, E.Galeazzi, M.Meroni, PierluigiDerksen, R. H. W. M.de Groot, P. G. D.Baleva, M.Mosca, MartaBombardieri, S.Houssiau, Frédéric A.Gris, J-C.Quéré, I.Hachulla, EricVasconcelos, CarlosFernández-Nebro, AntonioHaro, M.Amoura, ZahirMiyara, M.Tektonidou, MariaEspinosa Garriga, GerardBertolaccini, M. L.Khamashta, Munther A.Bellisai, F.Síndrome antifosfolipídicaLupus eritematósMalalties autoimmunitàriesMorbiditatEstudi de casosAntiphospholipid syndromeLupus erythematosusAutoimmune diseasesMorbidityCase studiesOBJECTIVES: To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. METHODS: In 1999, we started an observational study of 1000 APS patients from 13 European countries. All had medical histories documented when entered into the study and were followed prospectively during the ensuing 10 years. RESULTS: 53.1% of the patients had primary APS, 36.2% had APS associated with systemic lupus erythematosus and 10.7% APS associated with other diseases. Thrombotic events appeared in 166 (16.6%) patients during the first 5-year period and in 115 (14.4%) during the second 5-year period. The most common events were strokes, transient ischaemic attacks, deep vein thromboses and pulmonary embolism. 127 (15.5%) women became pregnant (188 pregnancies) and 72.9% of pregnancies succeeded in having one or more live births. The most common obstetric complication was early pregnancy loss (16.5% of the pregnancies). Intrauterine growth restriction (26.3% of the total live births) and prematurity (48.2%) were the most frequent fetal morbidities. 93 (9.3%) patients died and the most frequent causes of death were severe thrombosis (36.5%) and infections (26.9%). Nine (0.9%) cases of catastrophic APS occurred and 5 (55.6%) of them died. The survival probability at 10 years was 90.7%. CONCLUSIONS: Patients with APS still develop significant morbidity and mortality despite current treatment. It is imperative to increase the efforts in determining optimal prognostic markers and therapeutic measures to prevent these complications.BMJ Publishing Group2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/119677Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1136/annrheumdis-2013-204838Annals of the Rheumatic Diseases, 2014, vol. 74, num. 6, p. 1011-1018https://doi.org/10.1136/annrheumdis-2013-204838(c) BMJ Publishing Group, 2014info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1196772026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| title |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| spellingShingle |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients Cervera i Segura, Ricard, 1960- Síndrome antifosfolipídica Lupus eritematós Malalties autoimmunitàries Morbiditat Estudi de casos Antiphospholipid syndrome Lupus erythematosus Autoimmune diseases Morbidity Case studies |
| title_short |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| title_full |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| title_fullStr |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| title_full_unstemmed |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| title_sort |
Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients |
| dc.creator.none.fl_str_mv |
Cervera i Segura, Ricard, 1960- Serrano, R. Pons-Estel, G. J. Ceberio-Hualde, L. Shoenfeld, Yehuda de Ramón, Enrique Buonaiuto, V. Jacobsen, Søren Zeher, M. M. Tarr, T. Tincani, Angela Taglietti, M. Theodossiades, G. Nomikou, E. Galeazzi, M. Meroni, Pierluigi Derksen, R. H. W. M. de Groot, P. G. D. Baleva, M. Mosca, Marta Bombardieri, S. Houssiau, Frédéric A. Gris, J-C. Quéré, I. Hachulla, Eric Vasconcelos, Carlos Fernández-Nebro, Antonio Haro, M. Amoura, Zahir Miyara, M. Tektonidou, Maria Espinosa Garriga, Gerard Bertolaccini, M. L. Khamashta, Munther A. Bellisai, F. |
| author |
Cervera i Segura, Ricard, 1960- |
| author_facet |
Cervera i Segura, Ricard, 1960- Serrano, R. Pons-Estel, G. J. Ceberio-Hualde, L. Shoenfeld, Yehuda de Ramón, Enrique Buonaiuto, V. Jacobsen, Søren Zeher, M. M. Tarr, T. Tincani, Angela Taglietti, M. Theodossiades, G. Nomikou, E. Galeazzi, M. Meroni, Pierluigi Derksen, R. H. W. M. de Groot, P. G. D. Baleva, M. Mosca, Marta Bombardieri, S. Houssiau, Frédéric A. Gris, J-C. Quéré, I. Hachulla, Eric Vasconcelos, Carlos Fernández-Nebro, Antonio Haro, M. Amoura, Zahir Miyara, M. Tektonidou, Maria Espinosa Garriga, Gerard Bertolaccini, M. L. Khamashta, Munther A. Bellisai, F. |
| author_role |
author |
| author2 |
Serrano, R. Pons-Estel, G. J. Ceberio-Hualde, L. Shoenfeld, Yehuda de Ramón, Enrique Buonaiuto, V. Jacobsen, Søren Zeher, M. M. Tarr, T. Tincani, Angela Taglietti, M. Theodossiades, G. Nomikou, E. Galeazzi, M. Meroni, Pierluigi Derksen, R. H. W. M. de Groot, P. G. D. Baleva, M. Mosca, Marta Bombardieri, S. Houssiau, Frédéric A. Gris, J-C. Quéré, I. Hachulla, Eric Vasconcelos, Carlos Fernández-Nebro, Antonio Haro, M. Amoura, Zahir Miyara, M. Tektonidou, Maria Espinosa Garriga, Gerard Bertolaccini, M. L. Khamashta, Munther A. Bellisai, F. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Síndrome antifosfolipídica Lupus eritematós Malalties autoimmunitàries Morbiditat Estudi de casos Antiphospholipid syndrome Lupus erythematosus Autoimmune diseases Morbidity Case studies |
| topic |
Síndrome antifosfolipídica Lupus eritematós Malalties autoimmunitàries Morbiditat Estudi de casos Antiphospholipid syndrome Lupus erythematosus Autoimmune diseases Morbidity Case studies |
| description |
OBJECTIVES: To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. METHODS: In 1999, we started an observational study of 1000 APS patients from 13 European countries. All had medical histories documented when entered into the study and were followed prospectively during the ensuing 10 years. RESULTS: 53.1% of the patients had primary APS, 36.2% had APS associated with systemic lupus erythematosus and 10.7% APS associated with other diseases. Thrombotic events appeared in 166 (16.6%) patients during the first 5-year period and in 115 (14.4%) during the second 5-year period. The most common events were strokes, transient ischaemic attacks, deep vein thromboses and pulmonary embolism. 127 (15.5%) women became pregnant (188 pregnancies) and 72.9% of pregnancies succeeded in having one or more live births. The most common obstetric complication was early pregnancy loss (16.5% of the pregnancies). Intrauterine growth restriction (26.3% of the total live births) and prematurity (48.2%) were the most frequent fetal morbidities. 93 (9.3%) patients died and the most frequent causes of death were severe thrombosis (36.5%) and infections (26.9%). Nine (0.9%) cases of catastrophic APS occurred and 5 (55.6%) of them died. The survival probability at 10 years was 90.7%. CONCLUSIONS: Patients with APS still develop significant morbidity and mortality despite current treatment. It is imperative to increase the efforts in determining optimal prognostic markers and therapeutic measures to prevent these complications. |
| publishDate |
2014 |
| dc.date.none.fl_str_mv |
2014 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/2445/119677 |
| url |
https://hdl.handle.net/2445/119677 |
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Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Reproducció del document publicat a: https://doi.org/10.1136/annrheumdis-2013-204838 Annals of the Rheumatic Diseases, 2014, vol. 74, num. 6, p. 1011-1018 https://doi.org/10.1136/annrheumdis-2013-204838 |
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(c) BMJ Publishing Group, 2014 info:eu-repo/semantics/openAccess |
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(c) BMJ Publishing Group, 2014 |
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openAccess |
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application/pdf |
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BMJ Publishing Group |
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BMJ Publishing Group |
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Articles publicats en revistes (Medicina) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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Universidad de Barcelona |
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Dipòsit Digital de la UB |
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Dipòsit Digital de la UB |
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15,301603 |