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Triple positive profile in antiphospholipid syndrome: prognosis, relapse and management from a retrospective multicentre study.
Laurent, Charlotte; Ricard, Laure; Nguyen, Yann; Boffa, Jean Jacques; Rondeau, Eric; Gerotziafas, Grigorios; Elalamy, Ismail; Deriaz, Sophie; De Moreuil, Claire; Planche, Virginie; Johanet, Cathererine; Millot, Francois; Fain, Olivier; Mekinian, Arsène.
Afiliación
  • Laurent C; Sorbonne Université, AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Hôpital Saint-Antoine, F-75012, Paris, France.
  • Ricard L; Sorbonne Université, AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Hôpital Saint-Antoine, F-75012, Paris, France.
  • Nguyen Y; Service de médecine médecine interne, AP-HP.Nord, Hôpital Beaujon, Université de Paris, Clichy, France.
  • Boffa JJ; Service de Néphrologie et dialyses, Hôpital Tenon, Paris, France.
  • Rondeau E; Service des urgences néphrologiques et transplantation rénale, Hôpital Tenon, Paris, France.
  • Gerotziafas G; Service d'hématologie biologique, Hôpital Tenon, Paris, France.
  • Elalamy I; Service d'hématologie biologique, Hôpital Tenon, Paris, France.
  • Deriaz S; Service de médecine interne, Centre hospitalier et universitaire Bretonneau, Tours, France.
  • De Moreuil C; Service de médecine interne, Centre hospitalier et universitaire Brest, Brest, France.
  • Planche V; Sorbonne Université, Service de Hématologie biologique, AP-HP, Hôpital Saint-Antoine, 75012, Paris, France.
  • Johanet C; Immunology Department, Saint-Antoine Hospital Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
  • Millot F; Service de médecine interne, Centre hospitalier et universitaire Bretonneau, Tours, France.
  • Fain O; Sorbonne Université, AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Hôpital Saint-Antoine, F-75012, Paris, France.
  • Mekinian A; Sorbonne Université, AP-HP, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DMU i3), Hôpital Saint-Antoine, F-75012, Paris, France arsene.mekinian@aphp.fr.
RMD Open ; 9(1)2023 03.
Article en En | MEDLINE | ID: mdl-37001919
OBJECTIVE: Antiphospholipid syndrome (APS) is defined by the association of thromboembolic and/or obstetrical clinical manifestations and the presence of antiphospholipid antibodies. The objective of our study was to evaluate the impact of the triple-positive profile in a cohort of 204 APS patients. METHODS: We conducted a retrospective study, including patients with primary or secondary APS, meeting the Sydney criteria with at least one thrombotic and/or obstetrical complication. Clinical characteristics and the risk of relapse (defined by the occurrence of a new thrombotic event and/or a new adverse obstetrical event) between triple-positive and non-triple-positive APS patients were compared. RESULTS: 204 patients were included in our study, 68 were triple-positive and 136 were single or double positive. 122 patients (59.8%) had primary APS. 67 patients (32.8%) had obstetrical APS, with a higher rate among triple-positive patients (45.6% vs 26.5%, p=0.010), and 170 patients (83.3%) had thrombotic APS, without difference between triple-positive and others. Thrombotic events were more often venous (56.4%) than arterial (37.7%). Triple-positive patients had more placental complications than others (17.6% vs 2.9%, p=0.001) and more non-criteria events (48.5% vs 25.7%, p=0.002). Among non-criteria events, there was a higher frequency of Sneddon syndrome in triple-positive patients (7.4% vs 0.7%, p=0.028). The relapse rate was higher in triple-positive patients than in others (63.2% vs 39,7%, p=0002). In multivariate analysis, the triple-positive profile was associated with a higher risk of relapse (HR 1.63; 95% CI 1.04 to 2.55; p=0.031). CONCLUSION: The triple-positivity is associated with a higher risk of relapse and obstetrical complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Síndrome Antifosfolípido Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: RMD Open Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Síndrome Antifosfolípido Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Pregnancy Idioma: En Revista: RMD Open Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido