Farina, Nicola;
Abdulsalam, Ruya;
McDonnell, Thomas;
Pericleous, Charis;
D'Souza, Amrita;
Ripoll, Vera M;
Webster, Jemma;
... Rahman, Anisur; + view all
(2022)
Antiphospholipid antibody positivity in early systemic lupus erythematosus is associated with subsequent vascular events.
Rheumatology
10.1093/rheumatology/keac596.
(In press).
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Abstract
OBJECTIVE: Antiphospholipid antibodies (aPL) are found in the blood of 20-30% of patients with systemic lupus erythematosus (SLE). Although aPL cause vascular thrombosis in the antiphospholipid syndrome it is not clear whether positive aPL levels in early SLE increase risk of subsequent vascular events (VE). In a previous analysis of 276 patients with SLE, we found that early positivity for ≥2 of IgG anti-cardiolipin (anti-CL), IgG anti-beta2glycoprotein I (anti-β2GPI) and anti-Domain I of beta2glycoprotein I (anti-DI) showed a possible association with VE. Here we have extended that analysis. METHODS: Serum samples taken from 501 patients with SLE early in their disease had been tested for IgG anti-CL, anti-β2GPI and anti-DI by ELISA. Complete VE history was available for 423 patients of whom 23 were excluded because VE occurred before the diagnosis of SLE. For the remaining 400 patients we carried out Kaplan-Meier survival analysis to define groups at higher risk of VE. RESULTS: Of 400 patients, 154 (38.5%) were positive for one or more aPL; 27 (6.8%) were double/triple-positive and 127 (31.8%) were single-positive. There were 91 VE in 77 patients, of whom 42 were aPL-positive in early disease. VE were significantly increased in aPL-positive versus aPL-negative patients (p= 0.041) and in double/triple-positive versus single-positive versus aPL-negative patients (p= 0.0057).Omission of the IgG anti-DI assay would have missed 14 double/triple-positive patients of whom 6 had VE. CONCLUSION: Double/triple-positivity for IgG anti-CL, anti- anti-β2GPI and anti-DI in early SLE identifies a population at higher risk of subsequent VE.
| Type: | Article |
|---|---|
| Title: | Antiphospholipid antibody positivity in early systemic lupus erythematosus is associated with subsequent vascular events |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/rheumatology/keac596 |
| Publisher version: | https://doi.org/10.1093/rheumatology/keac596 |
| Language: | English |
| Additional information: | © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/). |
| Keywords: | Systemic lupus erythematosus, antiphospholipid antibodies, cardiovascular |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10157739 |
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