Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION): 10-Year Update

Abstract

Purpose of Review APS ACTION is an international research network created to design and conduct large-scale, multicenter research in persistently antiphospholipid antibody (aPL)–positive patients. Given the expanding research activities of the network in the last decade since its creation, the purpose of this article is to review the scientific contributions of APS ACTION as well as future directions. Recent Findings APS ACTION has achieved increased international collaboration with internal and external investigators for outcome, interventional, and mechanistic antiphospholipid syndrome (APS) studies. This has been linked to substantial progress in Core laboratory work, which has demonstrated that laboratories can achieve good agreement in performance of aPL assays by use of the same reagents, analyzer type, and protocols. Summary APS ACTION will continue to identify gaps in the existing aPL/APS literature, design mechanistic studies to elucidate underlying mechanisms, and conduct prospective, large-scale clinical studies, all for the ultimate goal of early diagnosis and improved management of aPL-positive patients.

Primary Anti-Phospholipid Antibody Syndrome: Real-World Defining Features of Rethrombosis in the Course of Disease

“…In both groups, a minority of patients reverted to negative status along follow-up. Our results are in line with the previous observation that aPL profiles are stable in 80% of the patients, more frequently observed in LA or triple aPL positivity over a median follow-up of 5 years [9].…”

“…Recently, a larger panel of auto-antibodies and clinical features have been highlighted as contributors for a PAPS diagnosis [ 9 ], but these do not benefit previously diagnosed patients. The global APS score (GAPSS) as well as aGAPSS have helped stratify patients with a high probability of developing recurrent thrombosis [ 10 ].…”

Immune Thrombocytopenia in Antiphospholipid Syndrome: Is It Primary or Secondary?

“…It should be based on regular assay of antibodies titer and control of any other modifiable risk factor for thrombosis, along with the treatment of any underlying known autoimmune disease [42], whether or not within this context. Risk stratification, which may also include additional "non criteria" manifestations, such as thrombocytopenia, needs to be clarified yet [43,44].…”

Antibodies to Neutrophil Extracellular Traps: Novel Markers for the Antiphospholipid Syndrome

“…The study by Zuo and colleagues represents valuable scholarship from an international scientific enterprise known as the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Network (APS ACTION) (5). Founded in 2010, APS ACTION conducts research and clinical trials on patients who remain persistently positive for aPL, most especially those with APS who have arterial and venous thrombosis as well as pregnancy loss and other systemic complications.…”