THU0367 Prevalence and significance of anti-phosphatidylserine antibodies: a pooled analysis in 5992 patients

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 400
• Main Authors: Radin, M., Cecchi, I., Rubini, E., Karen, S., Roccatello, D., Mahler, M., Sciascia, S.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Antiphospholipid syndrome; Autoimmune diseases; Cardiolipin; Classification; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Morbidity; Phosphatidylserine; Pregnancy; Thrombosis
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.3443

BackgroundThe current classification criteria for antiphospholipid syndrome (APS) include three laboratory tests: lupus anticoagulant, anti-cardiolipin, and anti-b2 glycoprotein-I[.1 Among the so-called ‘extra-criteria’ aPL tests, anti-phosphatidylserine (aPS) antibodieshave been proposed as an additional tool to be considered when patient is suspected for having APS. However the exact prevalence of aPS antibodies, and their independent role as risk factor for developing clinical manifestations of APS, is uncertain.ObjectivesTo estimate the prevalence of aPS antibodies in patients with clinical manifestations of APS, by systematically reviewing the literature.MethodsA detailed literature search was applied a priori to Ovid MEDLINE, In-Process and Other Non-Indexed Citation 1989 to present and to abstracts from EULAR and ACR/ARHP Annual Meetings (2011–2017) (figure 1).ResultsData from 5992 patients from 20 studies were analysed (table 1). In APS patients, we report an overall estimated median prevalence of aPS antibodies of 55% [S.D±21.1, range 29%–87%] and 35% [S.D.±17.9, 16–65%] for IgG and IgM, respectively. aPS antibodies were more frequently found in patients with known APS, when compared to patients with thrombosis/pregnancy loss or SLE(IgG mean 55%±28.9, 30±19.6, 22±13; IgM 35±4.3,1±2.8, 14±8.3, respectively, p<0.05). In detail, patients were distributed as follow:366 APS patients in 7 studies [55% aPS IgG/37% aPS IgM-positive; in more detail, 78 primary APS in 2 studies (64% aPS IgG/48% aPS IgM-positive), 29 secondary APS in 2 studies (37%aPS IgG/24% aPS IgM-positive) and 259 not specified], 787SLE patients in 7 studies (22%aPS IgG/14% aPS IgM-positive), 24aPLasymptomatic carriers in one study (21% aPS IgG/25% aPS IgM-positive), 3565 patients with cardiovascular accidents in 4 studies (18% aPS IgG/7% aPS IgM-positive), 1250 patients with pregnancy morbidity in 6 studies (30% aPS IgG/1% aPS IgM-positive) and 952 healthy controls.ConclusionsWhile aPS are frequently detected in patients with known APS, their added diagnostic value and clinical role in patients with thrombosis/pregnancy loss and/or concomitant autoimmune disease remain uncertain.Reference[1] Miyakis S, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J. Thromb. Haemost2006;4(2):295–306.Disclosure of InterestNone declared