Lupus Anticoagulant and Antiphospholipid Antibodies: A Real-World Study

E. Kempers¹, V.A.S.H. Dalm², M.J.E. van Rijn³, A.G.M.G.J. Mulders⁴, F.W.G. Leebeek¹, M.P.M. de Maat¹, A.J.G. Jansen¹

¹Erasmus University Medical Center, Hematology, Rotterdam, the Netherlands, ²Erasmus University Medical Center, Internal Medicine and Immunology, Rotterdam, the Netherlands, ³Erasmus University Medical Center, Vascular Surgery, Rotterdam, the Netherlands, ⁴Erasmus University Medical Center, Obstetrics and Gynecology, Rotterdam, the Netherlands

Abstract Number: PB1898

Meeting: ISTH 2020 Congress

Theme: Thrombotic Microangiopathies » Antiphospholipid Syndrome

Background: Antiphospholipid antibodies (aPL) are a heterogeneous group of antibodies that can interact with phospholipids, phospholipid-binding proteins, or both and its presence is associated with increased risk of thrombosis. aPL are routinely measured in daily clinical practice for diagnostic purposes in autoimmune diseases or to detect risk factors after obstetric complications or thrombosis. Data on incidence of aPL positivity and characteristics of patients with positive aPL are scarce.

Aims: To identify patients with positive aPL, including lupus anticoagulant, anticardiolipin antibodies and anti-β2GPI antibodies, and to determine the association with antiphospholipid syndrome (APS) and thrombosis.

Methods: On average 770 patients are tested annually for aPL at the Erasmus MC. In this single center retrospective study all first positive aPL samples between June 2015 till April 2018 were collected as were the patients’ clinical characteristics.

Results: Out of 2147 patients, 284 patients had ≥1 positive aPL test result. 93 patients met the revised Sapporo criteria for APS, with significantly higher titers of all aPL than patients who did not meet these criteria. APS patients were treated by internists (63.4%), gynecologists (22.6%) and neurologists (14.0%). 54.8% of the APS patients were newly diagnosed. APS patients were single positive for aPL (N=36), double positive (N=15), triple positive (N=17) or had incomplete results (N=25). Of the non-APS patients, 20 were single, 8 double, and 3 triple positive, and 157 had incomplete aPL results. Triple positive aPL and presence of anti-β2GPI IgG were the strongest predictors for thrombosis. 69 APS patients were treated with different anticoagulant therapy, of whom 6 with DOAC.

Conclusions: This study identifies characteristics of patients with positive aPL. Triple positive aPL was also found in patients without APS. Triple positive aPL and anti-β2GPI IgG were the strongest predictors for thrombosis. Variation in anticoagulant therapy in patients with APS necessitates increase of the awareness.

To cite this abstract in AMA style:

Kempers E, Dalm VASH, van Rijn MJE, Mulders AGMGJ, Leebeek FWG, de Maat MPM, Jansen AJG. Lupus Anticoagulant and Antiphospholipid Antibodies: A Real-World Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/lupus-anticoagulant-and-antiphospholipid-antibodies-a-real-world-study/. Accessed November 29, 2023.

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