Damage measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody-positive patients included in the APS ACTION registry

Balbi, GGM; Ahmadzadeh, Y; Tektonidou, MG; Pengo, V; Sciascia, S; Ugarte, A; Belmont, HM; Lopez-Pedrera, C; Fortin, PR; Wahl, D; Gerosa, M; de Jesús, GR; Ji, L; Atsumi, T; Efthymiou, M; Branch, DW; Nalli, C; Rodriguez Almaraz, E; Petri, M; Cervera, R; Knight, JS; Artim-Esen, B; Willis, R; Bertolaccini, ML; Cohen, H; Roubey, R; Erkan, D; de Andrade, DCO; for AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (APS ACTION)

doi:10.1093/rheumatology/kead292

Lupus & antiphospholipid syndrome

Damage measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody-positive patients included in the APS ACTION registry

Rheumatology (Oxford)Published 12 Jun 2023Cross-sectional study

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Authors' conclusion

DIAPS indicates substantial damage in aPL-positive patients in the APS ACTION cohort.

Study context

Population: aPL-positive patients with or without APS classification in the APS ACTION registry, excluding other autoimmune diseasesof 826 in registry
Participants: 586 patients

Exposure: Thrombotic APS with high vs low damage; non-thrombotic aPL-positive with vs without damage
Thromboticn = 412
Non-thromboticn = 174
Outcome: Damage burden measured by DIAPS
Follow-up: Baseline

Methodological detailsinternational registry cohort (APS ACTION)

International registry cohort (APS ACTION)

Main finding

As reported in the abstract

Damage burden (DIAPS)

DIAPS indicates substantial damage in aPL-positive patients

Observational data: associations, not effects.

Further findings

Factors independently associated with high damage, thrombotic group · baseline

	← Lower odds ←→ Higher odds →	OR (95% CI)	P value
Hyperlipidaemia	0.10.31310	1.82 (1.05–3.15)	adjusted P = 0.032
Obesity	0.10.31310	2.14 (1.23–3.71)	adjusted P = 0.007
aβ2GPI high titres	0.10.31310	2.33 (1.36–4.02)	adjusted P = 0.002
Corticosteroid use (ever)	0.10.31310	3.73 (1.80–7.75)	adjusted P < 0.001
	0.10.31310Odds ratio (log scale)

Factors independently associated with damage, non-thrombotic group · baseline

	← Lower odds ←→ Higher odds →	OR (95% CI)	P value
Hypertension	0.050.21520	4.55 (1.82–11.35)	adjusted P = 0.001
Hyperlipidaemia	0.050.21520	4.32 (1.37–13.65)	adjusted P = 0.013
Single aPL positivityInversely correlated with damage	0.050.21520	0.24 (0.075–0.77)	adjusted P = 0.016
	0.050.21520Odds ratio (log scale)

Original publication

Damage measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody-positive patients included in the APS ACTION registry. Rheumatology (Oxford). Published 12 June 2023. doi:10.1093/rheumatology/kead292

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