Clinical utility of the global anti-phospholipid syndrome score for risk stratification: a pooled analysis

Abstract

GAPSS may represent a useful tool to assess the thrombosis or pregnancy loss risk in aPL-positive patients, switching from the concept of aPL as a sole diagnostic antibody to aPL as risk factors for clinical events.

The adjusted global antiphospholipid syndrome score (aGAPSS) and the risk of recurrent thrombosis: Results from the APS ACTION cohort

“…Despite much data supporting the usefulness of antiphosphatidylserine/prothrombin (aPS/PT) antibodies as a diagnostic and prognostic biomarker, these antibodies are not included as a laboratory criterion for APS or used in the routine clinical setting, and therefore, were unavailable for this study [15]. For this reason, we performed our analysis using the previously validated adjusted GAPSS or aGAPSS, which excludes aPS/PT from the computation [3].…”

“…Recently, the global APS score (GAPSS),a risk score for clinical manifestations of APS, which incorporates independent cardiovascular disease risk factors and aPL profile, was developed. The Global APS Score, initially developed and validated in systemic lupus erythematosus (SLE), has been applied in a cohort of SLE patients followed prospectively, and then validated in APS patients without associated SLE [2][3][4][5][6]. Due to the relative low prevalence of APS in the general population, estimated as an incidence of five cases per 100,000 persons per year [7,8], APS clinical research requires international efforts and multicenter collaborations.…”

Anti-β2-glycoprotein I and anti-phosphatidylserine/prothrombin antibodies exert similar pro-thrombotic effects in peripheral blood monocytes and endothelial cells

“…Numbers of recent papers underlined the important role of aPS/PT antibodies, together with aβ2GPI, aCL and LAC, improving the diagnosis and prognosis of APS. Anti-PS/PT antibody assays demonstrated high diagnostic performance for patients with APS, but can also detect some APS patients negative for criteria antibodies [6] and may serve as potential risk predictors for venous thrombosis and obstetric complications [7, 8].…”

Translational validation of the Global Antiphospholipid Syndrome Score in patients with thrombotic APS

“…In 2018, the clinical utility of GAPSS/aGAPSS in a pooled analysis of 2273 patients reported higher values of GAPSS in patients with clinical manifestations of APS. Moreover, the highest values of GAPSS were associated with the most severe clinical manifestations of the disease (arterial thrombosis andrecurrent thrombotic events and/or pregnancy morbidity) [4]. Similarly, patients with higher aGAPSSvalues had more extra-criteria manifestations of APS [5].…”

“…These observations support the fact that higher GAPSS/aGAPSSvaluesfound in patients with higher pro-thrombotic profiles, assessed by a translationalapproach, are in line with the results by Pérez-Sánchez C. et al, who investigatedthe clinical role for the use of microRNAs ratiosto stratify patients according to their thrombotic risk. They performed a cluster analysis in this APS cohort, demonstrating that patients with a high rate of multiple aPL positivity, arterial thrombosis and lower rate of cardiovascular risk factors showed higher aGAPSS comparedtopatients with a high rate of multiple aPL positivity, venous thrombosis and lower prevalence of cardiovascular risk factors [4]. Similarly, the higher aGAPSS scores significantly correlated with serum levels of B-cell stimulating factor in a cohort of primary APS patients (r=0.40, p=0.03) [7].…”