Lupus & antiphospholipid syndrome
Fluctuation of Anti–Domain 1 and Anti–β2‐Glycoprotein I Antibody Titers Over Time in Patients With Persistently Positive Antiphospholipid Antibodies
Authors' conclusion
Treatment with HCQ and incident vascular events in aPL-positive patients predicted significant anti-D1 and anti-β2 GPI titer fluctuations over time. Both anti-D1 and anti-β2 GPI titers decreased around the time of thrombosis, with potential clinical relevance.
Study context
- Population
- Patients persistently positive for aPL in the APS ACTION Registry with blood samples from at least 4 time points
- Participants
- 230 participants
- Outcome
- Longitudinal anti-β2 GPI and anti-D1 IgG titers; predictors of titer variation; whether titer fluctuations predict thrombosis
- Follow-up
- Years 1-4
Methodological detailsinternational registry (APS ACTION Registry), samples from at least 4 time points (baseline [year 1] and years 2-4), chemiluminescence (BIO-FLASH)
- International registry (APS ACTION Registry)
- Samples from at least 4 time points (baseline [year 1] and years 2-4)
- Chemiluminescence (BIO-FLASH)
Main finding
As reported in the abstract
- Anti-D1 titers decreased significantly over time
- P < 0.0001
- Anti-β2 GPI titers decreased significantly over time
- P = 0.010
- Hydroxychloroquine (HCQ) (not immunosuppressive agents) associated with decrease in anti-D1 titers (adjusted for age, sex, number of positive aPL tests)
- 1.3-fold
- HCQ (not immunosuppressive agents) associated with decrease in anti-β2 GPI titers (adjusted for age, sex, number of positive aPL tests)
- 1.4-fold
- Incident vascular events associated with increase in anti-D1 titers
- 1.9-fold
- Incident vascular events associated with increase in anti-β2 GPI titers
- 2.1-fold
Observational data: associations, not effects.
Further findings
Incident thrombosis by titer decrease
| OR (95% CI) | ||
|---|---|---|
| 1.6-fold decrease in anti-D1 titers | 6.0 (0.62–59.3) | |
| 2-fold decrease in anti-β2 GPI titers | 9.4 (1.1–80.2) | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Fluctuation of Anti–Domain 1 and Anti–β2‐Glycoprotein I Antibody Titers Over Time in Patients With Persistently Positive Antiphospholipid Antibodies. Arthritis Rheumatol. Published 2 April 2023. doi:10.
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