Diagnostic value of anti-annexin A5 antibodies in seropositive versus seronegative antiphospholipid syndrome patients

Omar, Gihan; Mohamed, Faten Ismail; Sadek, Hanaa A.; Mamdouh, Al Shimaa

doi:10.1016/j.ejr.2017.07.003

Cited by 6 publications

(9 citation statements)

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“…Two studies derive from multicentric European registries ( 26 , 38 ), and the remainder were performed in eight different countries. Most studies originated from Western Europe ( 4 , 12 , 26 – 29 , 32 , 33 , 38 ), followed by Asia ( 30 , 31 , 37 , 39 ), North Africa ( 35 ), the Middle East ( 34 ) and South America ( 36 ). Consecutive sampling was used in most studies (n=11) ( 4 , 12 , 27 – 30 , 32 – 35 , 37 ), while one study used a convenience sample ( 26 ), and three did not specifically state their sampling method ( 31 , 36 , 39 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies originated from Western Europe ( 4 , 12 , 26 – 29 , 32 , 33 , 38 ), followed by Asia ( 30 , 31 , 37 , 39 ), North Africa ( 35 ), the Middle East ( 34 ) and South America ( 36 ). Consecutive sampling was used in most studies (n=11) ( 4 , 12 , 27 – 30 , 32 – 35 , 37 ), while one study used a convenience sample ( 26 ), and three did not specifically state their sampling method ( 31 , 36 , 39 ). Thirteen studies provided information on the comparison between the clinical manifestations of non-criteria and definite APS ( 4 , 12 , 26 – 28 , 30 , 32 – 36 , 38 , 39 ), while nine studies compared outcomes and therapies used ( 4 , 26 , 29 – 33 , 37 , 38 ).…”

Section: Resultsmentioning

confidence: 99%

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Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review

et al. 2022

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ObjectivesPatients with laboratory or clinical manifestations suggestive of antiphospholipid syndrome (APS) but not fulfilling the classification criteria constitute a clinical challenge. This study aims to compare non-criteria APS (NC-APS) with definite APS in terms of clinical manifestations, therapies, and outcomes.MethodsA systematic review of observational studies comparing definite and NC-APS was performed searching four electronic databases. Data on clinical manifestations, therapies and clinical outcomes was extracted.ResultsSixteen studies, assessing a total of 3,798 participants, were included. Seven out of 10 studies found no significant difference in the prevalence of arterial or venous thrombosis between definite and NC-APS, with two studies on seronegative APS also finding no difference in thrombosis recurrence. Seven out of 12 studies found no significant difference in the prevalence of obstetric manifestations between groups, with the remaining exhibiting conflicting results. In 9 studies comparing treatment frequency in obstetric patients, all but one described similar treatment frequency, with the percentage of NC-APS treated during pregnancy ranging from 26% to 100%. In 10 studies comparing pregnancy outcomes of NC-APS versus definite APS, 7 found similar successful pregnancies/live births. Additionally, 5 studies described improvement of live births in both groups with treatment, with three signalling aspirin monotherapy as efficacious as combination therapy in NC-APS.ConclusionThis review hints at an absence of marked differences in most evaluated parameters between definite and NC-APS, emphasizing the value of a more active follow-up of these patients. The low-quality available evidence highlights the need for well-defined NC-APS populations in future studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42020210674.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review

et al. 2022

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“…Antiphospholipid syndrome (APS) is an autoimmune-mediated acquired thrombophilia. 1,2 It is defined as a syndrome of recurrent venous and/or arterial thromboses, pregnancy complication together with the presence of antiphospholipid antibodies (aPL), that are directed against phospholipid-binding plasma proteins. [1][2][3] Thrombocytopenia is one of the most common non-criteria findings in APS patients.…”

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confidence: 99%

“…1,2 It is defined as a syndrome of recurrent venous and/or arterial thromboses, pregnancy complication together with the presence of antiphospholipid antibodies (aPL), that are directed against phospholipid-binding plasma proteins. [1][2][3] Thrombocytopenia is one of the most common non-criteria findings in APS patients. 4 The estimated prevalence of thrombocytopenia in patients with APS ranged from 20 to 53%, depending on the cut-off value used (<100¥10 9 /L or <150¥10 9 /L), 5 and the frequency of patients with primary APS (PAPS) and secondary APS (SAPS) in the studied cohort.…”

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confidence: 99%

Thrombocytopenia in a cohort of primary and secondary antiphospholipid syndrome patients: Relation to clinical, laboratory manifestations and damage index

2022

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Objectives: This study aims to evaluate the prevalence of thrombocytopenia in a cohort of patients with primary and secondary antiphospholipid syndrome (APS) and to examine the relation of thrombocytopenia to the clinical, laboratory findings, and damage index for antiphospholipid syndrome (DIAPS). Patients and methods: Between August 2018 and February 2019, a total of 168 patients (16 males, 152 females; mean age: 32.5±8.4 years; range, 18 to 59 years) who were followed in our clinic for APS were retrospectively analyzed. Medical records of the patients were screened and clinical data, laboratory investigations, and treatments applied were recorded. The DIAPS was calculated for all patients. The patients were divided into two groups according to the presence or absence of thrombocytopenia and both groups were compared regarding clinical, laboratory findings and DIAPS. Further subgroup analysis was done for patients with primary APS. Results: The most common clinical manifestations in our patients were obstetric manifestations (77.4% in pregnant women), musculoskeletal manifestations (69%) and peripheral vascular thrombosis (54.8%). The prevalence of thrombocytopenia in our study was 42.3%, and it was significantly associated with musculoskeletal manifestations (p=0.043), vascular thrombosis (p=0.043), neurological manifestations (p=0.030), cutaneous manifestations (p=0.006), and use of immunosuppressives (p=0.047). The DIAPS was significantly higher in the thrombocytopenia group (p=0.034). Further subgroup analysis of patients with primary APS revealed that neurological manifestations (p=0.010) were significantly higher in the thrombocytopenia group, while the DIAPS was higher in the thrombocytopenia group, but it did not reach statistical significance (p=0.082). Conclusion: Thrombocytopenia may be associated with a higher incidence of vascular thrombosis, neurological manifestations, musculoskeletal manifestations, use of immunosuppressive treatment, and DIAPS. In primary APS patients, thrombocytopenia may be a risk for neurological manifestations.

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“…Most studies focused on "seronegative" and "incomplete laboratory" APS. [4] 25 24 Ofer-Shiber, 2015 [5] 126 117 Mekinian, 2016 [6] 83 96 Omar, 2018 [7] 30 30 Signorelli, 2017 [8] 77 13 Fredi, 2018 [9] 85 81 Litvinova, 2018 [10] 41 17 Alijotas-Reig, 2019 [11] 1000 640 Ferreira, 2020 [12] 15 21 Liu, 2020 [13] 192 90 Li, 2020 [14] 34 94 Lo, 2020 [15] 12 24…”

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confidence: 99%

Pos0767 clinical Manifestations, Treatment, and Outcomes of “Non-Criteria” Antiphospholipid Syndrome in Comparison With Definite Antiphospholipid Syndrome: A Systematic Review and Meta-Analysis

Rosa¹,

Ferreira²,

Sousa‐Pinto³

et al. 2021

Ann Rheum Dis

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Background:Patients with laboratorial or clinical manifestations suggestive of antiphospholipid syndrome (APS) but not fulfilling the classification criteria [1] constitute a challenge in clinical practice.Objectives:To establish a comparison between patients with “non-criteria” versus those with definite APS on the frequency of clinical manifestations, prescribed therapies and reported outcomes.Methods:A systematic review of observational studies comparing “non-criteria” with definite APS patients was performed searching 4 electronic databases. Data was extracted on clinical manifestations, therapies and outcomes. Studies were analyzed globally and, where possible, grouped under four potential “non-criteria” APS subsets. Random-effects meta-analyses were performed.Results:Fourteen studies were included, assessing a total of 3,238 participants (Table 1). In the meta-analysis, no difference was detected in the frequency of arterial events or thrombosis recurrence between “non-criteria” and definite APS. However, a lower frequency of venous events was observed in “non-criteria” patients (risk ratio [RR]=0.9; 95%CI 0.7-1.0; p-value=0.047, I2=0%; Q Cochran p-value=0.226). Regarding obstetric morbidity, no difference was observed in most outcomes, but previous history of intrauterine growth restriction was less frequent (RR=0.7; 95%CI=0.6-0.9; p-value=0.003, I2=0%; Q Cochran p-value=0.228) and the risk of prematurity in followed pregnancies lower in “non-criteria” patients. There was no significant difference in treatment frequency between groups, except for less use of hydroxychloroquine in “non-criteria” APS (RR=0.7; 95%CI=0.5-0.9; p-value=0.007, I2=46.5%; Q Cochran p-value=0.642). There was no significant difference in the risk of fetal loss between groups either with or without treatment (Figure 1). It should be noted that significant heterogeneity was observed in some outcomes across the studied categories. Most studies focused on “seronegative” and “incomplete laboratory” APS.Table 1.Description of studies included in the systematic review.Author, year (reference)Number of PatientsDefinite APSNC-APS(global)Mekinian, 2012 [2]2553Rodriguez-Garcia, 2012 [3]8767Conti, 2014 [4]2524Ofer-Shiber, 2015 [5]126117Mekinian, 2016 [6]8396Omar, 2018 [7]3030Signorelli, 2017 [8]7713Fredi, 2018 [9]8581Litvinova, 2018 [10]4117Alijotas-Reig, 2019 [11]1000640Ferreira, 2020 [12]1521Liu, 2020 [13]19290Li, 2020 [14]3494Lo, 2020 [15]1224Abbreviations – APS: Antiphospholipid Syndrome; NC-APS: Non-criteria antiphospholipid syndrome.Conclusion:This review suggests an absence of marked differences in most of the evaluated variables regarding clinical manifestations, treatment and outcomes between “non-criteria” and definite APS. These results should be interpreted with caution in light of the low-quality evidence available and heterogeneity observed in some outcomes.References:[1]S Miyakis et al., J Thromb Haemost 4 (2), 295 (2006).[2]A Mekinian et al., Journal of Reproductive Immunology 94 (2), 222 (2012).[3]JL Rodriguez-Garcia et al., Ann Rheum Dis 71 (2), 242 (2012).[4]F Conti et al., J Immunol Res 2014, 389601 (2014).[5]S Ofer-Shiber and Y Molad, Blood Coagul Fibrinolysis 26 (3), 261 (2015).[6]A Mekinian et al., Semin Arthritis Rheum 46 (2), 232 (2016).[7]G Omar et al., Egyptian Rheumatologist 40 (2), 111 (2018).[8]F Signorelli et al., Annals of the Rheumatic Diseases 76, 887 (2017).[9]M Fredi et al., Front Immunol 9, 864 (2018).[10]E Litvinova et al., Front Immunol 9, 2971 (2018).[11]J Alijotas-Reig et al., Rheumatology (Oxford) (2019).[12]TG Ferreira et al., Clin Rheumatol 39 (4), 1167 (2020).[13]T Liu et al., Arthritis Res Ther 22 (1), 33 (2020).[14]X Li et al., Clinical Rheumatology (2020).[15]HW Lo et al., Eur J Obstet Gynecol Reprod Biol 244, 205 (2020).Figure 1.Forest plot of studies included in the meta-analysis regarding pregnancy and treatment outcomes.Acknowledgements:The authors wish to thank Helena Donato, from the Documentation Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, for her assistance performing the search for the systematic review.Disclosure of Interests:None declared

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Diagnostic value of anti-annexin A5 antibodies in seropositive versus seronegative antiphospholipid syndrome patients

Cited by 6 publications

References 31 publications

Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review

Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review

Thrombocytopenia in a cohort of primary and secondary antiphospholipid syndrome patients: Relation to clinical, laboratory manifestations and damage index

Pos0767 clinical Manifestations, Treatment, and Outcomes of “Non-Criteria” Antiphospholipid Syndrome in Comparison With Definite Antiphospholipid Syndrome: A Systematic Review and Meta-Analysis

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