Lupus & antiphospholipid syndrome
Assessment of triple antiphospholipid antibody-positive patients based on clinical and laboratory domains of 2023 ACR/EULAR antiphospholipid syndrome classification criteria
Authors' conclusion
Our findings highlight distinct clinical profiles in triple aPL-positive patients based on aCL/aβ2GPI isotypes. While IgG (±IgM) isotypes were associated with higher clinical domain scores and severe manifestations, the role of IgM-only isotypes warrants further mechanistic and clinical investigation even in triple aPL profile.
Study context
- Population
- Triple aPL-positive patients (persistently positive LA, aCL IgG/M ≥ 40 ELISA Units, aβ2GPI IgG/M ≥ 40 ELISA Units), Antiphospholipid Syndrome (APS)-specialized practice cohort, Feb 2016-May 2024of 751 patients in cohort
- Participants
- 193 patients
- Exposure
- aCL/aβ2GPI IgG vs IgM-only in triple aPL-positive patients
- IgG (±IgM)n = 165
- IgM-onlyn = 28reference
- Outcome
- Clinical domain involvement (2023 ACR/EULAR APS CC), all triple aPL-positive
Methodological detailsAPS-specialized practice cohort
- APS-specialized practice cohort
Main finding
As reported in the abstract
- Macrovascular VTE
- 46 %
- Macrovascular arterial thrombosis
- 39 %
- Microvascular
- 35 %
- Obstetric
- 46 %
- Cardiac valve
- 16 %
- Hematologic
- 34 %
Observational data: associations, not effects.
Further findings
- IgG (±IgM) had significantly higher 2023 ACR/EULAR Classification Criteria (CC) total clinical domain score, greater macrovascular and microvascular involvement, and higher use of long-term anticoagulation, steroids and immunosuppression vs IgM-only
- Almost half of IgM-only patients, who were older, lacked clinical domain involvement
Original publication
Assessment of triple antiphospholipid antibody-positive patients based on clinical and laboratory domains of 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Semin Arthritis Rheum. Published 5 June 2025. doi:10.
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