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Thromb Haemost 2019; 119(12): 1920-1926
DOI: 10.1055/s-0039-1696687
Coagulation and Fibrinolysis
Georg Thieme Verlag KG Stuttgart · New York

Prevalence of Antiphospholipid Antibodies Negativisation in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Multicentre Study

Massimo Radin‡   *
1   Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, University of Turin, Turin, Italy
,
Karen Schreiber‡   *
2   Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, United Kingdom
3   Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark
,
Savino Sciascia
1   Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, University of Turin, Turin, Italy
,
Dario Roccatello
1   Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, University of Turin, Turin, Italy
,
Irene Cecchi
1   Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, University of Turin, Turin, Italy
,
María Ángeles Aguirre Zamorano
4   Department of Rheumatology, University Hospital “Reina Sofia,” Cordoba, Spain
,
Maria Jose Cuadrado
5   Department of Rheumatology, Clinica Universidad de Navarra, Madrid, Spain
› Author Affiliations Funding None.
Further Information

Publication History

03 May 2019

19 July 2019

Publication Date:
06 October 2019 (online)

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Abstract

Objective This article aims to analyse the rate of antiphospholipid antibodies (aPL) negativisation in patients with antiphospholipid syndrome (APS), and to evaluate potential new clinical manifestations after negativisation and/or aPL fluctuations in a long-term follow-up.

Methods Inclusion criteria are (1) any patients with an APS diagnosis according to the current Sydney criteria and (2) patients in whom aPL negativisation occurred. aPL negativisation was defined as repeated aPL measurements on at least two consecutive occasions at least 12 weeks apart, with a follow-up of at least 1 year since aPL first turned negative.

Results Out of 259 APS patients, a total of 23 patients (8.9%) met the inclusion criteria for persistent aPL negativisation. Patients were followed-up for 14.4 ± 8.1 years, experienced aPL negativisation after a mean of 5.3 ± 3.5 years and were followed-up after experiencing the aPL negativisation for a mean of 7.6 ± 5.8 years. Seventeen patients (73.9%) presented with thrombotic APS, 2 with pregnancy morbidity (8.7%) and 4 (17.4%) with both. Most of the patients (18; 78.3%) had a single aPL positivity, 5 (21.7%) double, while no triple aPL positivity was observed. At the time of data collection, after aPL negativisation, anticoagulation was stopped in 8 patients with previous thrombotic venous event (8/21, 38%) according to the treating physicians' judgements. None of the patients experienced any recurrent thrombotic event during the follow-up period after their aPL negativisation.

Conclusion In our patient cohort consisting of 259 patients with definitive APS, we observed over a mean observation period of > 5 years, that aPL negativisation occurred in approximately 9% of patients. Negativisation occurred most often in patients who were previously found to be positive for only one aPL.

Keywords

antiphospholipid syndrome - antiphospholipid antibodies - negativisation - anticoagulation - thrombosis

Authors' Contributions

M.R., S.S., I.C. and K.S. retrieved data from patients' files, drafted the manuscript and tables and critically reviewed the manuscript. M.R., S.S., I.C., D.R., M.A. and M.C. drafted the manuscript and critically reviewed the manuscript.


* Equally contributed to this study.