TY - JOUR
T1 - Antiphospholipid autoantibody detection is important in all patients with systemic autoimmune diseases
AU - PRECISESADS Clinical Consortium
AU - Marziale, Adrien
AU - Bettacchioli, Eléonore
AU - Picart, Gael
AU - Nafai, Salma
AU - Galinat, Hubert
AU - Meroni, Pier Luigi
AU - Frostegard, Johan
AU - Alarcon-Riquelme, Marta E.
AU - Renaudineau, Yves
N1 - Funding Information:
This work has received support from the EU/ EFPIA Innovative Medicines Initiative Joint Undertaking (PRECISESADS, grant n. 115565 ) including in-kind contributions from the EFPIA members involved.
Funding Information:
The work described has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement No. 115565 , the resources for which are composed of a financial contribution from the European Union's Seventh Framework Programme ( FP7/2007–2013 ) and the European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in-kind contribution. We thank all the members of PRECISESADS Consortium and INSERM U1227 for their effort in the sample recruitment, distribution and assessment of the samples used in this study. We are grateful to Dr Wesley H. Brooks (Tampa, USA) for editorial assistance and to Valerie Le Troadec for secretarial assistance.
Publisher Copyright:
© 2020 Elsevier Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Antiphospholipid (aPL) autoantibodies are uncommon in systemic autoimmune diseases (SADs). However, the European PRECISESADS study provides the opportunity to better characterize this rare association. The study was composed of 1818 patients with SADs including 453 with systemic lupus erythematosus (SLE), 359 with rheumatoid arthritis (RA), 385 with systemic sclerosis (SSc), 367 with Sjögren's syndrome (SjS), 94 with mixed connective tissue disease (MCTD), and 160 with undifferentiated connective tissue disease (UCTD). Assays used for aPL determination include the lupus anticoagulant (LAC) analysis using the dilute Russell's viper venom time (dRVVT) assay plus anti-cardiolipin (aCL) and anti-aβ2GPI autoantibodies of IgG and IgM isotype. Information regarding clinical and biological characteristics of SAD patients was available. Among SAD patients, the prevalence of aPL differs significantly between two groups: SLE (57.6%) and non-SLE SADs (13.7%, p < 10−4). Next, association between aPL plus thrombosis and miscarriage were observed in both SLE and non-SLE patients. Thrombosis was best predicted in SLE patients by dRVVT (OR = 6.1; IC95:3.5–10.3) and miscarriage by aCL±β2GPI IgG (OR = 2.5; IC95:1.2–5.2); while in non-SLE SADs the best predictors were aCL±β2GPI IgG for thrombosis (OR = 6.6; IC95:2.4–18.4) and aCL±β2GPI IgM for miscarriage (OR = 2.9; IC95:1.2–6.8). In the case of multiple positivity of aPL, the risk for thrombosis and miscarriage was increased. Central nervous system involvement characterized the SLE patients, in contrast to pulmonary and skin fibrosis, valve lesions, hypertension, elevated creatinemia, C4 fraction reduction, platelet reduction and inflammation that characterized the non-SLE SAD patients. Anti-PL determination remains important in SADs patients and should not be restricted to only SLE patients.
AB - Antiphospholipid (aPL) autoantibodies are uncommon in systemic autoimmune diseases (SADs). However, the European PRECISESADS study provides the opportunity to better characterize this rare association. The study was composed of 1818 patients with SADs including 453 with systemic lupus erythematosus (SLE), 359 with rheumatoid arthritis (RA), 385 with systemic sclerosis (SSc), 367 with Sjögren's syndrome (SjS), 94 with mixed connective tissue disease (MCTD), and 160 with undifferentiated connective tissue disease (UCTD). Assays used for aPL determination include the lupus anticoagulant (LAC) analysis using the dilute Russell's viper venom time (dRVVT) assay plus anti-cardiolipin (aCL) and anti-aβ2GPI autoantibodies of IgG and IgM isotype. Information regarding clinical and biological characteristics of SAD patients was available. Among SAD patients, the prevalence of aPL differs significantly between two groups: SLE (57.6%) and non-SLE SADs (13.7%, p < 10−4). Next, association between aPL plus thrombosis and miscarriage were observed in both SLE and non-SLE patients. Thrombosis was best predicted in SLE patients by dRVVT (OR = 6.1; IC95:3.5–10.3) and miscarriage by aCL±β2GPI IgG (OR = 2.5; IC95:1.2–5.2); while in non-SLE SADs the best predictors were aCL±β2GPI IgG for thrombosis (OR = 6.6; IC95:2.4–18.4) and aCL±β2GPI IgM for miscarriage (OR = 2.9; IC95:1.2–6.8). In the case of multiple positivity of aPL, the risk for thrombosis and miscarriage was increased. Central nervous system involvement characterized the SLE patients, in contrast to pulmonary and skin fibrosis, valve lesions, hypertension, elevated creatinemia, C4 fraction reduction, platelet reduction and inflammation that characterized the non-SLE SAD patients. Anti-PL determination remains important in SADs patients and should not be restricted to only SLE patients.
KW - Anti-cardiolipin
KW - Anti-β2GPI
KW - Antiphospholipid autoantibodies
KW - dRVVT
KW - Systemic autoimmune diseases
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U2 - 10.1016/j.jaut.2020.102524
DO - 10.1016/j.jaut.2020.102524
M3 - Article
C2 - 32693965
AN - SCOPUS:85088110580
VL - 115
JO - Journal of Autoimmunity
JF - Journal of Autoimmunity
SN - 0896-8411
M1 - 102524
ER -