Lupus & antiphospholipid syndrome
Antiphospholipid antibody trajectories and clinical correlates in an inception cohort of systemic lupus erythematosus
Authors' conclusion
In early SLE, aPLs are largely low-titre and fluctuating, with some patients evolving to higher-risk states
Study context
- Population
- Patients with newly diagnosed systemic lupus erythematosus (SLE) (median disease duration 232 days [114–484]), INSPIRE registry
- Participants
- 270 patients
- Exposure
- aPL trajectory groups: persistently negative, positive, fluctuating or negativised
- Outcome
- Longitudinal aPL patterns and association with vascular events, disease activity and organ damage
Methodological detailsinception cohort, INSPIRE registry, serum at baseline, 6 and 24 months
- Inception cohort
- INSPIRE registry
- Serum at baseline, 6 and 24 months
Main finding
As reported in the abstract
aPL patterns
aPL-positive at least once, predominantly low-titre
77.1%
Progressed from negative/low-titre to high-risk profiles
3.1%
aPL negativisation, inversely associated with baseline aPL burden
12.5%
Observational data: associations, not effects.
Further findings
- Thrombosis · two years — Persistently negative
- 0 events
- Thrombosis — Developed thrombosis (all patients)
- 19 (7%)
Thrombosis · two years
- Higher risk in high-risk and persistently positive groups
Disease activity, serology and damage
- aPL titres did not correlate with SLEDAI-2K or Physician Global Assessment (PGA)
- Anti-cardiolipin (aCL) IgG and anti-β2GPI IgG correlated weakly with anti-dsDNA
- SLICC/ACR Damage Index (SDI) remained low across groups
Original publication
Antiphospholipid antibody trajectories and clinical correlates in an inception cohort of systemic lupus erythematosus. Rheumatology (Oxford). Published 7 August 2026. doi:10.
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