Clinical thrombotic manifestations in SLE patients with and without antiphospholipid antibodies: A 5-year follow-up

T. Tarr, Gabriella Lakos, H. Bhattoa, P. Soltész, Yehuda Shoenfeld, G. Szegedi, E. Kiss

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Abstract

Objective: To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used. Methods: 272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients' medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up. Results: The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL- group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50% risk to develop thrombotic complications. The aPL+ group (n≤81) consisted of aPL+ but APS- patients. LAC was the most common aPL (n≤27, 32.1%) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5%) from the aPL- group, of whom 3 (2.8%) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2%) aPL+ patients within 5 years. New thrombotic events occurred in 3.7% of aPL+ (n≤3) and 8.3% (n≤7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9%) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9%) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5-3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin+cumarine). Conclusion: The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalClinical Reviews in Allergy and Immunology
Volume32
Issue number2
DOIs
Publication statusPublished - Apr 2007

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Antiphospholipid Antibodies
Systemic Lupus Erythematosus
Antiphospholipid Syndrome
Lupus Coagulation Inhibitor
beta 2-Glycoprotein I
Cardiolipins
Transient Ischemic Attack
Aspirin
Stroke
International Normalized Ratio
Antibodies
Anticoagulants

Keywords

  • APS
  • Follow-up
  • LAC
  • Primary prophylaxis
  • SLE

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

@article{600c0837094c42c1a5691671252ed9b6,
title = "Clinical thrombotic manifestations in SLE patients with and without antiphospholipid antibodies: A 5-year follow-up",
abstract = "Objective: To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used. Methods: 272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients' medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up. Results: The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL- group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50{\%} risk to develop thrombotic complications. The aPL+ group (n≤81) consisted of aPL+ but APS- patients. LAC was the most common aPL (n≤27, 32.1{\%}) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5{\%}) from the aPL- group, of whom 3 (2.8{\%}) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2{\%}) aPL+ patients within 5 years. New thrombotic events occurred in 3.7{\%} of aPL+ (n≤3) and 8.3{\%} (n≤7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9{\%}) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9{\%}) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5-3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin+cumarine). Conclusion: The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.",
keywords = "APS, Follow-up, LAC, Primary prophylaxis, SLE",
author = "T. Tarr and Gabriella Lakos and H. Bhattoa and P. Solt{\'e}sz and Yehuda Shoenfeld and G. Szegedi and E. Kiss",
year = "2007",
month = "4",
doi = "10.1007/s12016-007-0009-8",
language = "English",
volume = "32",
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issn = "1080-0549",
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TY - JOUR

T1 - Clinical thrombotic manifestations in SLE patients with and without antiphospholipid antibodies

T2 - A 5-year follow-up

AU - Tarr, T.

AU - Lakos, Gabriella

AU - Bhattoa, H.

AU - Soltész, P.

AU - Shoenfeld, Yehuda

AU - Szegedi, G.

AU - Kiss, E.

PY - 2007/4

Y1 - 2007/4

N2 - Objective: To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used. Methods: 272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients' medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up. Results: The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL- group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50% risk to develop thrombotic complications. The aPL+ group (n≤81) consisted of aPL+ but APS- patients. LAC was the most common aPL (n≤27, 32.1%) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5%) from the aPL- group, of whom 3 (2.8%) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2%) aPL+ patients within 5 years. New thrombotic events occurred in 3.7% of aPL+ (n≤3) and 8.3% (n≤7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9%) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9%) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5-3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin+cumarine). Conclusion: The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.

AB - Objective: To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used. Methods: 272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients' medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up. Results: The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL- group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50% risk to develop thrombotic complications. The aPL+ group (n≤81) consisted of aPL+ but APS- patients. LAC was the most common aPL (n≤27, 32.1%) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5%) from the aPL- group, of whom 3 (2.8%) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2%) aPL+ patients within 5 years. New thrombotic events occurred in 3.7% of aPL+ (n≤3) and 8.3% (n≤7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9%) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9%) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5-3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin+cumarine). Conclusion: The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.

KW - APS

KW - Follow-up

KW - LAC

KW - Primary prophylaxis

KW - SLE

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