Obstetrical outcome and treatments in seronegative primary APS : data from European retrospective study
Abisror, Noemie (Sorbonne Université)
Nguyen, Yann (Paris University)
Marozio, Luca (University of Torino)
Esteve Valverde, Enrique (Althaia Xarxa Assistencial (Manresa))
Udry, Sebastian (Acute Hospital "Dr Carlos G Durand")
Pleguezuelo, Daniel Enrique (Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12))
Billoir, Paul (Rouen University Hospital (França))
Mayer-Pickel, Karoline (Medical University of Graz)
Urbanski, Geoffrey (CHU d'Angers)
Zigon, Polona (University Medical Centre Ljubljana)
De Moreuil, Claire (Université Bretagne Loire)
Hoxha, Ariela (University of Padua)
Bezanahary, Holy (University Hospital of Limoges)
Carbillon, Lionel (Sorbonne University)
Kayem, Gilles (Sorbonne Université)
Bornes, Marie (Tenon Hospital)
Yelnik, Cecile (Université de Lille)
Johanet, Cathererine (Hôpital Saint Antoine)
Nicaise-Roland, Pascale (Bichat Hospital)
Lambert, Marc (Université de Lille)
Salle, Valéry (University Hospital of Amiens)
Latino, Omar Jose (Acute Hospital "Dr Carlos G Durand")
Hachulla, Eric (Université de Lille)
Benedetto, Chiara (University of Torino)
Bourrienne, Marie Charlotte (Hôpital Bichat)
Benhamou, Ygal (Rouen University Hospital (França))
Alijotas-Reig, Jaume (Universitat Autònoma de Barcelona. Departament de Medicina)
Fain, Olivier (Sorbonne Université)
Mekinian, Arsène (Sorbonne Université)

Data:	2020
Resum:	To compare characteristics, pregnancies and treatments during pregnancies of seronegative and seropositive antiphospholipid syndrome (APS), to analyse factors associated with obstetrical outcome. Inclusion criteria were: (1) thrombotic and/or obstetrical APS (Sydney criteria); (2) absence of conventional antiphospholipid antibodies (APL); (3) at least one persistent non-conventional APL among IgA anticardiolipin antibodies, IgA anti-B2GPI, anti-vimentin G/M, anti-annexin V G/M, anti-phosphatidylethanolamine G/M and anti-phosphatidylserine/prothrombin G/M antibodies. The exclusion criteria were: (1) systemic lupus erythematosus (SLE) or SLE-like disease; and (2) other connective tissue disease. A total of 187 women (mean 33±5 years) with seronegative APS were included from 14 centres in Austria, Spain, Italy, Slovenia and France and compared with 285 patients with seropositive APS. Seronegative APS has more obstetrical rather than thrombotic phenotypes, with only 6% of venous thrombosis in comparison to seropositive APS. Cumulative incidence of adverse obstetrical events was similar in seronegative and seropositive APS patients, although higher rates of intrauterine deaths (15% vs 5%; p=0. 03), of preeclampsia (7% vs 16%, p=0. 048) and lower live birth term (36±3 vs 38±3 weeks of gestation; p=0. 04) were noted in seropositive APS. The cumulative incidence of adverse obstetrical events was significantly improved in treated versus untreated seronegative APS (log rank<0. 05), whereas there was no difference between patients who received aspirin or aspirin-low-molecular weighted heparin combination. Several non-criteria APL can be detected in patients with clinical APS features without any conventional APL, with various rates. The detection of non-criteria APL and thus the diagnosis of seronegative APS could discuss the therapeutic management similar to seropositive APS, but well-designed controlled studies are necessary.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Antibodies ; Antiphospholipid ; Antiphospholipid Syndrome ; Outcome and Process Assessment ; Health Care
Publicat a:	RMD Open, Vol. 6 (august 2020) , ISSN 2056-5933

DOI: 10.1136/rmdopen-2020-001340
PMID: 32848089

7 p, 556.8 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats