Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from the EUROAPS registry
Por:
Alijotas-Reig, J, Esteve-Valverde, E, Ferrer-Oliveras, R, Saez-Comet, L, Lefkou, E, Mekinian, A, Belizna, C, Ruffatti, A, Hoxha, A, Tincani, A, Nalli, C, Marozio, L, Maina, A, Espinosa, G, Rios-Garces, R, Cervera, R, De Carolis, S, Monteleone, G, Latino, O, Udry, S, Llurba, E, Garrido-Gimenez, C, Trespidi, L, Gerosa, M, Chighizola, CB, Rovere-Querini, P, Canti, V, Mayer-Pickel, K, Tabacco, S, Arnau, A, Trape, J, Ruiz-Hidalgo, D, Sos, L, Farran-Codina, I, EUROAPS Study Grp
Publicada:
1 jun 2020
Resumen:
Objectives. To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS).
Methods. This was a retrospective and prospective multicentre study from the European Registry on Obstetric Antiphospholipid Syndrome.
Results. A total of 1650 women with 5251 episodes, 3601 of which were historical and 1650 latest episodes, were included. Altogether, 1000 cases (OAPS group) fulfilled the Sydney classification criteria and 650 (NC-OAPS group) did not. Ten NC-OAPS cases were excluded for presenting thrombosis during follow-up. All cases were classified as category I (triple positivity or double positivity for aPL) or category II (simple positivity). Overall, aPL laboratory categories showed significant differences: 29.20% in OAPS vs 17.96% in NC-OAPS (P < 0.0001) for category I, and 70.8% in OAPS vs 82% in NC-OAPS (P < 0.0001) for category II. Significant differences were observed when current obstetric complications were compared (P < 0.001). However, major differences between groups were not observed in treatment rates, livebirths and thrombotic complications. In the NC-OAPS group, 176/640 (27.5%) did not fulfil Sydney clinical criteria (subgroup A), 175/640 (27.34%) had a low titre and/or non-persistent aPL positivity but did meet the clinical criteria (subgroup B) and 289/640 (45.15%) had a high aPL titre but did not fulfil Sydney clinical criteria (subgroup C).
Conclusion. Significant clinical and laboratory differences were found between groups. Fetal-maternal outcomes were similar in both groups when treated. These results suggest that we could improve our clinical practice with better understanding of NC-OAPS patients.
Filiaciones:
Alijotas-Reig, J:
Vall dHebron Univ Hosp, Dept Internal Med, Syst Autoimmune Dis Unit, Barcelona, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Esteve-Valverde, E:
Althaia Healthcare Univ Network Manresa, Internal Med Dept, Syst Autoimmune Dis Unit, Barcelona, Spain
Ferrer-Oliveras, R:
Hosp Quiron, Obstet & Gynaecol Dept, Barcelona, Spain
Saez-Comet, L:
Miguel Servet Univ Hosp, Internal Med Dept, Zaragoza, Spain
Lefkou, E:
Hippokration Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
Mekinian, A:
UPMC Univ, Serv Med Interne & Inflammat, Immunopathol Biotherapy Dept DHU i2B, Sorbonne Univ,Hop St Antoine,AP HP, Paris, France
Belizna, C:
Univ Hosp Angers, Vasc & Coagulat Dept, Angers, France
CNRS, INSERM Unit 6015 1083, Angers, France
Ruffatti, A:
Univ Padua, Dept Med DIMED, Rheumatol Unit, Padua, Italy
Hoxha, A:
Univ Padua, Dept Med DIMED, Rheumatol Unit, Padua, Italy
Tincani, A:
Univ Brescia, Dept Clin & Expt Sci, Rheumatol & Clin Immunol Unit, Brescia, Italy
Nalli, C:
Univ Brescia, Dept Clin & Expt Sci, Rheumatol & Clin Immunol Unit, Brescia, Italy
Marozio, L:
Univ Torino, Dept Obstet & Gynaecol, Turin, Italy
Maina, A:
AO Citta Salute & Sci Torino, Dept Internal Med, Turin, Italy
Espinosa, G:
Univ Barcelona, Hosp Clin, Inst Recerca Biomed August Pi & Sunyer IDIBAPS, Dept Autoimmune Dis, Barcelona, Spain
Rios-Garces, R:
Univ Barcelona, Hosp Clin, Inst Recerca Biomed August Pi & Sunyer IDIBAPS, Dept Autoimmune Dis, Barcelona, Spain
Cervera, R:
Univ Barcelona, Hosp Clin, Inst Recerca Biomed August Pi & Sunyer IDIBAPS, Dept Autoimmune Dis, Barcelona, Spain
De Carolis, S:
Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Salute Donna Bambino & Sanita Pu, UOC Patol Ostet, Rome, Italy
Univ Cattolica Sacro Cuore, Ist Clin Ostet & Ginecol, Rome, Italy
Monteleone, G:
Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Salute Donna Bambino & Sanita Pu, UOC Patol Ostet, Rome, Italy
Latino, O:
Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, DF, Argentina
Udry, S:
Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, DF, Argentina
Llurba, E:
Univ Hosp Santa Creu & St Pau, Obstet & Gynaecol Dept, High Risk Unit, Barcelona, Spain
Garrido-Gimenez, C:
Univ Hosp Santa Creu & St Pau, Obstet & Gynaecol Dept, High Risk Unit, Barcelona, Spain
Trespidi, L:
Fdn IRCCS Ca Granda, Obstet & Gynaecol Dept, Osped Maggiore Policlin, Milan, Italy
Gerosa, M:
Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
Chighizola, CB:
Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
Rovere-Querini, P:
IRCCS Osped San Raffaele Univ Vita Salute San Raf, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, Milan, Italy
Canti, V:
IRCCS Osped San Raffaele Univ Vita Salute San Raf, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, Milan, Italy
Mayer-Pickel, K:
Med Univ Graz, Dept Obstet, Graz, Austria
Tabacco, S:
Sapienza Univ Rome, Dept Gynecol Obstet & Urol, Rome, Italy
Arnau, A:
Univ Vic Cent Univ Catalonia, Althaia Healthcare Univ Network Manresa, Clin Res Unit, Barcelona, Spain
Trape, J:
Univ Vic Cent Univ Catalonia, Althaia Healthcare Univ Network Manresa, Dept Lab Med, Barcelona, Spain
Ruiz-Hidalgo, D:
Univ Vic Cent Univ Catalonia, Internal Med Dept, Althaia Healthcare Network Manresa, Barcelona, Spain
Sos, L:
Vilafranca del Penedes Hosp, Androl & Male Reprod Unit, Urol Dept, Barcelona, Spain
Farran-Codina, I:
Univ Autonoma Barcelona, Vall dHebron Univ Hosp, Obstet & Gynaecol Dept, Dept Med, Barcelona, Spain
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