Abstract
Objectives: Our primary objective was to quantify damage burden measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody (aPL)-positive patients with or without a history of thrombosis in an international cohort. Secondly, we aimed to identify clinical and laboratory characteristics associated with damage in aPL-positive patients.
Methods: In this cross-sectional study, we analyzed the baseline damage in aPL-positive patients with or without APS classification. We excluded patients with other autoimmune diseases. We analyzed the demographic, clinical, and laboratory characteristics based on two subgroups: (1) thrombotic APS patients with high versus low damage; and (2) non-thrombotic aPL-positive patients with versus without damage.
Results: Of the 826 aPL-positive patients included in the registry as of April 2020, 576 with no other systemic autoimmune diseases were included in the analysis (412 thrombotic and 164 non-thrombotic). In the thrombotic group, hyperlipidemia (OR 1.82, 95%CI 1.05-3.15, adjusted p= 0.032), obesity (OR 2.14, 95%CI 1.23-3.71, adjusted p= 0.007), aβ2GPI high titers (OR 2.33, 95%CI 1.36-4.02, adjusted p= 0.002), and corticosteroids use (ever) (OR 3.73, 95%IC 1.80-7.75, adjusted p< 0.001) were independently associated with high damage at baseline. In the non-thrombotic group, hypertension (OR 4.55, 95%CI 1.82-11.35, adjusted p= 0.001) and hyperlipidemia (OR 4.32, 95%CI 1.37-13.65, adjusted p= 0.013) were independent predictors of damage at baseline; conversely, single aPL positivity was inversely correlated with damage (OR 0.24; 95%CI 0.075-0,77, adjusted p= 0.016).
Conclusions: DIAPS indicates substantial damage in aPL-positive patients in APS ACTION cohort. Selected traditional cardiovascular risk factors, steroids use and specific aPL profiles may help to identify patients more prone to present with a higher damage burden.
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