MAY 2019

Semin Arthritis Rheum 2019;49(3):464-468  —  The adjusted global antiphospholipid syndrome score (aGAPSS) and the risk of recurrent thrombosis: Results from the APS ACTION cohort.The comparison of real world and core laboratory antiphospholipid antibody ELISA results from antiphospholipid syndrome alliance for clinical trials & international networking (APS ACTION) clinical database and repository analysis  —  Radin M, Sciascia S, Erkan D, Pengo V, Tektonidou MG, Ugarte A, Meroni P, Ji L, Belmont HM, Cohen H, Ramires de Jesús G, Branch DW, Fortin PR, Andreoli L, Petri M, Rodriguez E, Rodriguez-Pinto I, Knight JS, Atsumi T, Willis R, Gonzalez E, Lopez-Pedrera R, Rossi Gandara AP, Borges Gualhardo Vendramini M, Banzato A, Sevim E, Barbhaiya M, Efthymiou M, Mackie I, Bertolaccini ML, Andrade D; APS ACTION.

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OBJECTIVES:

To assess whether patients with antiphospholipid syndrome (APS) and history of recurrent thrombosis have higher levels of adjusted Global AntiphosPholipid Syndrome Score (aGAPSS) when compared to patients without recurrent thrombosis.

METHODS:

In this cross-sectional study of antiphospholipid antibody (aPL)-positive patients, we identified APS patients with a history of documented thrombosis from the AntiPhospholipid Syndrome Alliance For Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (“Registry”). Data on aPL-related medical history and cardiovascular risk factors were retrospectively collected. The aGAPSS was calculated at Registry entry by adding the points corresponding to the risk factors: three for hyperlipidemia, one for arterial hypertension, five for positive anticardiolipin antibodies, four for positive anti-β2 glycoprotein-I antibodies and four for positive lupus anticoagulant test.

RESULTS:

The analysis included 379 APS patients who presented with arterial and/or venous thrombosis. Overall, significantly higher aGAPSS were seen in patients with recurrent thrombosis (arterial or venous) compared to those without recurrence (7.8 ± 3.3 vs. 6 ± 3.9, p<0.05). When analyzed based on the site of the recurrence, patients with recurrent arterial, but not venous, thrombosis had higher aGAPSS (8.1 ± SD 2.9 vs. 6 ± 3.9; p<0.05).

CONCLUSIONS:

Based on analysis of our international large-scale Registry of aPL-positive patients, the aGAPSS might help risk stratifying patients based on the likelihood of developing recurrent thrombosis in APS.

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