The presence of non-criteria manifestations negatively affects the prognosis of seronegative antiphospholipid syndrome patients: a multicenter study.
Background: Seronegative antiphospholipid syndrome (SN-APS) is often defned as the presence of APS criteria manifestations, negative antiphospholipid antibodies (aPL), and coexistence of APS non-criteria manifestations. Nevertheless, the impact of these non-criteria features is still unclear. On a d...
| Autores: | , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/186526 |
| Acceso en línea: | https://hdl.handle.net/2445/186526 |
| Access Level: | acceso abierto |
| Palabra clave: | Malalties autoimmunitàries Síndrome antifosfolipídica Autoanticossos Lupus eritematós Embaràs Autoimmune diseases Antiphospholipid syndrome Autoantibodies Lupus erythematosus Pregnancy |
| Sumario: | Background: Seronegative antiphospholipid syndrome (SN-APS) is often defned as the presence of APS criteria manifestations, negative antiphospholipid antibodies (aPL), and coexistence of APS non-criteria manifestations. Nevertheless, the impact of these non-criteria features is still unclear. On a diferent note, the relevance of one single aPL positive determination in patients with APS manifestations is another domain with limited evidence. We aim to compare the course of SN-APS and single-positive aPL (SP-aPL) patients with that of individuals with APS manifesta‑ tions without non-criteria features/aPL positivity (controls). Methods: Retrospective analysis of patients with thrombosis/obstetric morbidity assessed in two European hospi‑ tals between 2005 and 2020. Patients were divided into SN-APS, SP-aPL, and control groups. Clinical characteristics, comorbidities, and therapies were compared. Results: A total of 82 patients were included in the SN-APS group, 88 in the SP-aPL group, and 185 in the control group. In Cox regression model, SN-APS displayed more thrombosis recurrence than controls (HR 3.8, 95% CI 2.2-6.5, p<0.001) even when adjusting for the presence of hereditary thrombophilia, systemic lupus erythematosus, or con‑ traceptive hormonal treatment. In SP-aPL, the diference in thrombosis recurrence did not reach statistical signifcance (p=0.078). Indefnite anticoagulation (p<0.001 and p=0.008, respectively) and vitamin K antagonist (VKA) use (p<0.001 in both cases) were more common in SN-APS/SP-aPL. Conclusion: SN-APS displayed more thrombosis recurrence, indefnite anticoagulation, and VKA use than controls without non-criteria manifestations. The presence of such features in patients with thrombosis and negative aPL may negatively impact their clinical course. Keywords: Antiphospholipid syndrome, Antiphospholipid antibodies, Seronegative, Single positive, Non-criteria manifestations |
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