Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from the EUROAPS registry

Autor: Alijotas-Reig, J., Esteve-Valverde, E., Ferrer-Oliveras, R., Saez-Comet, L., Lefkou, E., Mekinian, A., Belizna, C., Ruffatti, A., Hoxha, A., Tincani, A., Nalli, C., Marozio, L., Maina, A., Espinosa, G., Rios-Garces, R., Cervera, R., Carolis, S. D., Monteleone, G., Latino, O., Udry, S., Llurba, E., Garrido-Gimenez, C., Trespidi, L., Gerosa, M., Chighizola, C. B., Rovere-Querini, P., Canti, V., Mayer-Pickel, K., Tabacco, S., Arnau, A., Trape, J., Ruiz-Hidalgo, D., Sos, L., Farran-Codina, I.
Rok vydání: 2019
Předmět:
Adult
medicine.medical_specialty
medicine.drug_class
antiphospholipid
antiphospholipid antibodies
antiphospholipid syndrome
non-criteria antiphospholipid syndrome
obstetric antiphospholipid syndrome
outcomes
treatment
Antibodies
Antiphospholipid
Antiphospholipid Syndrome
Aspirin
Female
Humans
Live Birth
Pregnancy
Pregnancy Complications
Pregnancy Outcome
Prospective Studies
Registries
Retrospective Studies
Treatment Outcome
Low molecular weight heparin
Antibodies
03 medical and health sciences
0302 clinical medicine
Rheumatology
Antiphospholipid syndrome
medicine
Pharmacology (medical)
030212 general & internal medicine
Prospective cohort study
030203 arthritis & rheumatology
Obstetrics
business.industry
Retrospective cohort study
medicine.disease
Anti-thyroid autoantibodies
Clinical trial
Settore MED/40 - GINECOLOGIA E OSTETRICIA
Live birth
business
Zdroj: Rheumatology. 59:1306-1314
ISSN: 1462-0332
1462-0324
DOI: 10.1093/rheumatology/kez419
Popis: 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.
Databáze: OpenAIRE
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