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Alijotas-Reig J, Marques-Soares J, Esteve-Valverde E, Miró-Mur F, Belizna C, Udry S, Latino O, Ferrer-Oliveras R, Mekinian A, Saez-Comet L, de Carolis S, Hoxha A, Lefkou E, Llurba E, Rovere-Querini P, Tabacco S, Canti V. Correspondence and comments on American College of Rheumatology and EULAR antiphospholipid syndrome classification criteria: comment on the article by Barbhaiya et al. Arthritis Rheumatol 2024; 76:816-817. [PMID: 38200647 DOI: 10.1002/art.42792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/15/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Jaume Alijotas-Reig
- Vall d'Hebron University Hospital Vall d'Hebron Institut de Recerca and Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Joana Marques-Soares
- Vall d'Hebron University Hospital Vall d'Hebron Institut de Recerca and Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Enrique Esteve-Valverde
- Vall d'Hebron University Hospital Vall d'Hebron Institut de Recerca and Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Francesc Miró-Mur
- Vall d'Hebron University Hospital Vall d'Hebron Institut de Recerca and Universitat Autònoma de Barcelona, Catalonia, Spain
| | | | - Sebastian Udry
- Acute Hospital Dr. Carlos G. Durand, Buenos Aires, Argentina
| | - Omar Latino
- Acute Hospital Dr. Carlos G. Durand, Buenos Aires, Argentina
| | | | - Arsenne Mekinian
- Sorbonne Université - Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Luis Saez-Comet
- Hospital Universitario Miguel Servet and Aragon Health Sciences Institute, Zaragoza, Spain
| | - Sara de Carolis
- Fondazione Policlinico Universitario Policlinico Gemelli, Rome, Italy
| | | | | | - Elisa Llurba
- Sant Pau Research Institute Universitat Autònoma de Barcelona, Barcelona, Spain
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Esteve-Valverde E, Alijotas-Reig J, Belizna C, Marques-Soares J, Anunciacion-Llunell A, Feijóo-Massó C, Sáez-Comet L, Mekinian A, Ferrer-Oliveras R, Lefkou E, Morales-Pérez S, Hoxha A, Tincani A, Nalli C, Pardos-Gea J, Marozio L, Maina A, Espinosa G, Cervera R, De Carolis S, Latino O, Udry S, Llurba E, Garrido-Gimenez C, Trespidi L, Gerosa M, Chighizola CB, Rovere-Querini P, Canti V, Mayer-Pickel K, Tabacco S, Arnau A, Miró-Mur F. Corrigendum to "Low complement levels are related to poor obstetric outcomes in women with obstetric antiphospholipid syndrome. The EUROAPS Registry Study Group" [Placenta. 136 (2023 Apr 3) 29-34]. Placenta 2023; 138:20. [PMID: 37146536 DOI: 10.1016/j.placenta.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Enrique Esteve-Valverde
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain.
| | - Jaume Alijotas-Reig
- Systemic Autoimmune Diseases Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall D'Hebron University Hospital, Barcelona, Spain; Department of Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Belizna
- Vascular and Coagulation Department, University Hospital Angers and CNRS, 6015 INSERM 1083 Unit, Angers, France
| | - Joana Marques-Soares
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall D'Hebron University Hospital, Barcelona, Spain
| | | | - Carlos Feijóo-Massó
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Luis Sáez-Comet
- Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Arsene Mekinian
- AP-HP, Hôpital Saint-Antoine, Service de médecine interne and Inflammation- Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ, Paris, France
| | | | - Elmina Lefkou
- Haematology Unit, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Stephanie Morales-Pérez
- Internal Medicine Department, Althaia Healthcare University Network of Manresa, Systemic Autoimmune Disease Unit, Manresa, Barcelona, Spain
| | - Ariela Hoxha
- General Internal Medicine Unit, Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine-DIMED, University of Padua, Italy
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Cecilia Nalli
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Josep Pardos-Gea
- Systemic Autoimmune Diseases Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall D'Hebron University Hospital, Barcelona, Spain
| | - Luca Marozio
- Department of Obstetrics and Gynaecology, Università di Torino, Torino, Italy
| | - Aldo Maina
- Department of Internal Medicine, AO Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Sara De Carolis
- UOC di Patologia Ostetrica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Omar Latino
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Sebastian Udry
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Elisa Llurba
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen Garrido-Gimenez
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Trespidi
- Obstetrics and Gynaecology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Gerosa
- Division of Rheumatology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Cecilia B Chighizola
- Division of Rheumatology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Patrizia Rovere-Querini
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan, Italy
| | - Valentina Canti
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan, Italy
| | | | - Sara Tabacco
- Department of Gynecology Obstetrics and Urology, Sapienza, University of Rome, Rome, Italy
| | - Anna Arnau
- Research and Innovation Unit, Althaia Xarxa Assistencial Universitaria de Manresa, Manresa, Spain
| | - Francesc Miró-Mur
- Systemic Autoimmune Diseases Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
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Esteve-Valverde E, Alijotas-Reig J, Belizna C, Marques-Soares J, Anunciacion-Llunell A, Feijóo-Massó C, Sáez-Comet L, Mekinian A, Ferrer-Oliveras R, Lefkou E, Morales-Pérez S, Hoxha A, Tincani A, Nalli C, Pardos-Gea J, Marozio L, Maina A, Espinosa G, Cervera R, De Carolis S, Latino O, Udry S, Llurba E, Garrido-Gimenez C, Trespidi L, Gerosa M, Chighizola CB, Rovere-Querini P, Canti V, Mayer-Pickel K, Tabacco S, Arnau A, Miró-Mur F. Low complement levels are related to poor obstetric outcomes in women with obstetric antiphospholipid syndrome. The EUROAPS Registry Study Group. Placenta 2023; 136:29-34. [PMID: 37028222 DOI: 10.1016/j.placenta.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/21/2023] [Accepted: 04/01/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Obstetric antiphospholipid syndrome (OAPS) is an autoimmune disease related to antiphospholipid antibodies (aPL) with primaryinflammatory injury followed by clot cascade activation and thrombus formation. Complement system activation and their participation in aPL-related thrombosis is unclosed. METHODS We haveanalysed adverse pregnancy outcomes (APO) related to low complement (LC) levels in a cohort of 1048 women fulfilling classification criteria for OAPS. RESULTS Overall, 223 (21.3%) women presented LC values, during pregnancy. The length of pregnancy was shorter in OAPS women with LC compared to those with normal complement (NC) (median: 33 weeks, interquartile range: [24-38] vs. 35 weeks [27-38]; p = 0.022). Life new-born incidence was higher in patients with NC levels than in those with LC levels (74.4% vs. 67.7%; p = 0.045). Foetal losses were more related to women with triple or double aPL positivity carrying LC than NC values (16.3% vs. 8.0% NC; p = 0.027). Finally, some placental vasculopathies were affected in OAPS patients with LC as late Foetal Growth Restriction (FGR >34 weeks) rise to 7.2% in women with LC vs. 3.2% with NC (p = 0.007). DISCUSSION Data from our registry indicate that incidence of APO was higher in OAPS women with LC levels and some could be reverted by the correct treatment.
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Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, Sáez-Comet L, Lefkou E, Mekinian A, Belizna C, Ruffatti A, Hoxha A, Tincani A, Nalli C, Marozio L, Maina A, Espinosa G, Ríos-Garcés R, Cervera R, De Carolis S, Monteleone G, Latino O, Udry S, LLurba E, Garrido-Gimenez C, Trespidi L, Gerosa M, Chighizola CB, Rovere-Querini P, Canti V, Mayer-Pickel K, Tabacco S, Arnau A, Trapé J, Ruiz-Hidalgo D, Sos L, Farran-Codina I. Corrigendum to: Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from EUROAPS registry. Rheumatology (Oxford) 2021; 60:5883. [PMID: 34672326 DOI: 10.1093/rheumatology/keab659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona.,Department of Medicine, Universitat Autònoma, Barcelona
| | - Enrique Esteve-Valverde
- Internal Medicine Department, Althaia Healthcare University Network of Manresa, Systemic Autoimmune Disease Unit, Manresa, Barcelona
| | | | - Luis Sáez-Comet
- Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Elmina Lefkou
- Haematology Unit, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Arsène Mekinian
- AP-HP, Hôpital Saint-Antoine, Service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ, Paris
| | - Cristina Belizna
- Vascular and Coagulation Department, University Hospital Angers and CNRS, 6015 INSERM 1083 Unit, Angers, France
| | - Amelia Ruffatti
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Padua
| | - Ariela Hoxha
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Padua
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia
| | - Cecilia Nalli
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia
| | - Luca Marozio
- Department of Obstetrics and Gynaecology, Università di Torino, Torino
| | - Aldo Maina
- Department of Internal Medicine, AO Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roberto Ríos-Garcés
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Sara De Carolis
- UOC di Patologia Ostetrica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Istituto di Clinica Ostetrica e Ginecologica, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppina Monteleone
- UOC di Patologia Ostetrica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Omar Latino
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Sebastian Udry
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Elisa LLurba
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen Garrido-Gimenez
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Trespidi
- Obstetrics and Gynaecology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan
| | - Maria Gerosa
- Experimental Laboratory of Immunological and Rheumatologic Researches, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan
| | - Cecilia Beatrice Chighizola
- Experimental Laboratory of Immunological and Rheumatologic Researches, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan
| | - Patrizia Rovere-Querini
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan
| | - Valentina Canti
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan
| | | | - Sara Tabacco
- Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Anna Arnau
- Clinical Research Unit, Althaia Healthcare University Network of Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Jaume Trapé
- Department of Laboratory Medicine, Althaia Healthcare University Network of Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Domingo Ruiz-Hidalgo
- Internal Medicine Department, Althaia Healthcare Network of Manresa, Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Laia Sos
- Urology Department. Andrology and Male Reproductive Unit, Vilafranca del Penedès Hospital, Barcelona
| | - Inmaculada Farran-Codina
- Obstetrics and Gynaecology Department, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autònoma, Barcelona, Spain
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Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, Sáez-Comet L, Lefkou E, Mekinian A, Belizna C, Ruffatti A, Hoxha A, Tincani A, Nalli C, Marozio L, Maina A, Espinosa G, Ríos-Garcés R, Cervera R, Carolis SD, Monteleone G, Latino O, Udry S, LLurba E, Garrido-Gimenez C, Trespidi L, Gerosa M, Chighizola CB, Rovere-Querini P, Canti V, Mayer-Pickel K, Tabacco S, Arnau A, Trapé J, Ruiz-Hidalgo D, Sos L, Farran-Codina I. Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from the EUROAPS registry. Rheumatology (Oxford) 2020; 59:1306-1314. [PMID: 31580459 DOI: 10.1093/rheumatology/kez419] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/08/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS). METHODS This was a retrospective and prospective multicentre study from the European Registry on Obstetric Antiphospholipid Syndrome. RESULTS A total of 1650 women with 5251 episodes, 3601 of which were historical and 1650 latest episodes, were included. Altogether, 1000 cases (OAPS group) fulfilled the Sydney classification criteria and 650 (NC-OAPS group) did not. Ten NC-OAPS cases were excluded for presenting thrombosis during follow-up. All cases were classified as category I (triple positivity or double positivity for aPL) or category II (simple positivity). Overall, aPL laboratory categories showed significant differences: 29.20% in OAPS vs 17.96% in NC-OAPS (P < 0.0001) for category I, and 70.8% in OAPS vs 82% in NC-OAPS (P < 0.0001) for category II. Significant differences were observed when current obstetric complications were compared (P < 0.001). However, major differences between groups were not observed in treatment rates, livebirths and thrombotic complications. In the NC-OAPS group, 176/640 (27.5%) did not fulfil Sydney clinical criteria (subgroup A), 175/640 (27.34%) had a low titre and/or non-persistent aPL positivity but did meet the clinical criteria (subgroup B) and 289/640 (45.15%) had a high aPL titre but did not fulfil Sydney clinical criteria (subgroup C). CONCLUSION Significant clinical and laboratory differences were found between groups. Fetal-maternal outcomes were similar in both groups when treated. These results suggest that we could improve our clinical practice with better understanding of NC-OAPS patients.
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Affiliation(s)
- Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona.,Department of Medicine, Universitat Autònoma, Barcelona
| | - Enrique Esteve-Valverde
- Internal Medicine Department, Althaia Healthcare University Network of Manresa, Systemic Autoimmune Disease Unit, Manresa, Barcelona
| | | | - Luis Sáez-Comet
- Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Elmina Lefkou
- Haematology Unit, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Arsène Mekinian
- AP-HP, Hôpital Saint-Antoine, Service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC Univ, Paris
| | - Cristina Belizna
- Vascular and Coagulation Department, University Hospital Angers and CNRS, 6015 INSERM 1083 Unit, Angers, France
| | - Amelia Ruffatti
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Padua
| | - Ariela Hoxha
- Rheumatology Unit, Department of Medicine-DIMED, University of Padua, Padua
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia
| | - Cecilia Nalli
- Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia
| | - Luca Marozio
- Department of Obstetrics and Gynaecology, Università di Torino, Torino
| | - Aldo Maina
- Department of Internal Medicine, AO Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roberto Ríos-Garcés
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clinic, Institut de Recerca Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Sara De Carolis
- UOC di Patologia Ostetrica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Istituto di Clinica Ostetrica e Ginecologica, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppina Monteleone
- UOC di Patologia Ostetrica, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Omar Latino
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Sebastian Udry
- Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G. Durand Hospital, Buenos Aires, Argentina
| | - Elisa LLurba
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen Garrido-Gimenez
- Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Trespidi
- Obstetrics and Gynaecology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan
| | - Maria Gerosa
- Division of Rheumatology, Department of Clinical Sciences and Community Health, University of Milan, Milan
| | | | - Patrizia Rovere-Querini
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan
| | - Valentina Canti
- Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milan
| | | | - Sara Tabacco
- Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy
| | - Anna Arnau
- Clinical Research Unit, Althaia Healthcare University Network of Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Jaume Trapé
- Department of Laboratory Medicine, Althaia Healthcare University Network of Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Domingo Ruiz-Hidalgo
- Internal Medicine Department, Althaia Healthcare Network of Manresa, Manresa, University of Vic - Central University of Catalonia, Barcelona
| | - Laia Sos
- Urology Department. Andrology and Male Reproductive Unit, Vilafranca del Penedès Hospital, Barcelona
| | - Inmaculada Farran-Codina
- Obstetrics and Gynaecology Department, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autònoma, Barcelona, Spain
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Belizna C, Latino O, Stojanovich L, Saulnier P, Devreese K, Udry S, Stanisavljevic N, Djokovic A, Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, Tincani A, Andreoli L, Regola F, Limper M, Makatsariya A, Khizroeva J, Bitsadze V, Chighizola C, Pregnolato F, Borghi MO, Meroni PL. FRI0154 SHOULD BE OLDER PATIENTS TESTED FOR ANTIPHOSPHOLIPID ANTIBODIES? 695 CASES FROM THE RETROSPECTIVE SERIES HIBISCUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Although guidelines do not recommend antiphospholipid antibodies testing after 60 yo, recent data reported late onset antiphospholipid syndrome (APS).Objectives:To comparatively analyse the clinical, laboratory features and outcomes in 695 cases with primary APS between patients older and younger than 70 yo.Methods:we have performed an international study within the framework of the International Registry of primary APS patients treated with Hydroxychloroquine, HIBISCUS (an ongoing retrospective and prospective register launched in 2016). 28 centres from 17 countries participate. Data about late onset APS were analysed in 695 patients and were obtained from a standardized form registered in the database containing 66 items with respect to demographics, clinical and biological features.Results:Arterial events and especially stroke represented the main initial and recurrent clinical manifestation in 40 primary APS patients older than 70 yo. There were not statistically significant differences with respect to cardiovascular risk factors between the two groups of patients. A significant male predominance, a familial APS history, a higher prevalence of triple positivity, lower complement levels, and anticardiolipin antibodies (aCL) IgA isotype were found in older patients. Low anticoagulation regimens were safe and efficient, with a low relapse rate in older patients.Conclusion:we suggest that the detection of aPL antibodies should be included into the initial screening panel tests in elderly with thrombotic events, especially arterial, in particular those with recurrent stroke and familial APS.Our study further suggests that lower intensity anticoagulation regimens could be a therapeutic option in older APS patients, as no differences in outcomes and relapse rate were found between patients with high and low intensity anticoagulation regimens.References:[1]Grimaud F et al. Rheumatology. 2019;58:1006-10.[2]Goldman-Mazur S et al. Thromb Res. 2019;176:67-73.[3]Hirmerova J et al. 2017;36:167-73.Disclosure of Interests:Cristina Belizna: None declared, Omar Latino: None declared, Ljudmila Stojanovich: None declared, Patrick Saulnier: None declared, Katrien Devreese: None declared, Sebastien Udry: None declared, Natasa Stanisavljevic: None declared, Aleksandra Djokovic Speakers bureau: KRKA, Astra Zeneca, Actavis, Jaume Alijotas-Reig: None declared, Enrique Esteve-Valverde: None declared, Raquel Ferrer-Oliveras: None declared, Angela Tincani: None declared, Laura Andreoli: None declared, Francesca Regola: None declared, Maarten Limper: None declared, Alexander Makatsariya: None declared, Jamilya Khizroeva: None declared, Viktoria Bitsadze: None declared, Cecilia Chighizola: None declared, Francesca Pregnolato: None declared, Maria Orietta Borghi: None declared, Pier Luigi Meroni: None declared
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Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, Sáez-Comet L, Lefkou E, Mekinian A, Belizna C, Ruffatti A, Tincani A, Marozio L, Espinosa G, Cervera R, Ríos-Garcés R, De Carolis S, Latino O, LLurba E, Chighizola CB, Gerosa M, Pengo V, Lundelin K, Rovere-Querini P, Canti V, Mayer-Pickel K, Reshetnyak T, Hoxha A, Tabacco S, Stojanovich L, Gogou V, Varoudis A, Arnau A, Ruiz-Hidalgo D, Trapé J, Sos L, Stoppani C, Martí-Cañamares A, Farran-Codina I. The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases. Autoimmun Rev 2019; 18:406-414. [DOI: 10.1016/j.autrev.2018.12.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 12/08/2018] [Indexed: 11/17/2022]
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Udry S, Aranda F, Latino O, Larrañaga GD. [Annexins and recurrent pregnancy loss]. Medicina (B Aires) 2013; 73:495-500. [PMID: 24152411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Recurrent Pregnancy Loss (RPL) affects public health and directly compromises the quality of life of hundreds of women, with a detrimental effect on their physical and mental health. Approximately 50% of RPL are not associated to any of the currently known etiology and will be considered idiopathic. Recently, it has been demonstrated that the expression of annexin 5 (ANXA5), a protein found on the trophoblastic surface, plays a fundamental role in the development of pregnancy due to its immunomodulator and anticoagulant function at the placentary level. Some genetic haplotypes of ANXA5 are associated to alterations in the expression of this gene, such as haplotype M2 which is associated to a decrease in the expression of ANXA5. The presence of this haplotype is related to the following conditions occurring during pregnancy: RPL, foetal intrauterine growth restriction, low child weight at birth, preeclampsia and maternal pulmonary thromboembolism. This review describes the structure, function and genetic expression of ANXA5, as well as its possible implication in RPL.
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Affiliation(s)
- Sebastián Udry
- Consultorio de enfermedades autoinmunes trombofílicas y embarazo, Hospital Carlos G. Durand, Buenos Aires, Argentina
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