Natural history and risk factors for thrombosis in 360 patients with antiphospholipid antibodies: A four-year prospective study from the italian registry

Finazzi, Guido; Brancaccio, Vincenzo; Moia, Marco; Ciavarella, N.; Mazzucconi, Maria Gabriella; Schinco, Piercarla; Ruggeri, Marco; Pogliani, Enrico Maria; Gamba, G; Rossi, Edoardo; Baudo, F.; Manotti, Cesare; D’Angelo, Armando; Palareti, Gualtiero; Stefano, Valerio De; Berrettini, M; Barbui, Tiziano

doi:10.1016/s0002-9343(96)00060-5

Cited by 403 publications

(245 citation statements)

References 29 publications

Supporting

Mentioning

209

Contrasting

Unclassified

Order By: Relevance

“…In a 3-year prospective observational cohort study of 178 asymptomatic, persistently aPLpositive individuals without systemic autoimmune diseases, Giron-Gonzalez et al reported no thromboses in participants receiving no prophylaxis (except during high-risk periods such as surgeries) (16). In 2 other prospective observational cohort studies, the thrombosis incidence rates were 3.9% and 11.3% in followup periods of almost 4 years (0.95% and 3.01% annual incidence rate, respectively, assuming linear risk of thrombosis) (12,17). In a retrospective cohort study, Shah et al reported that 8 of 21 asymptomatic aCL-positive SLE patients (38%) had developed arterial thrombosis over 10 years (3.8% annual incidence rate) (11).…”

Section: Discussionmentioning

confidence: 96%

“…Based on a limited number of studies that predominantly include lupus patients, asymptomatic aPLpositive patients have a 0-3.8% annual thrombosis risk (11,12,(16)(17)(18). In a 3-year prospective observational cohort study of 178 asymptomatic, persistently aPLpositive individuals without systemic autoimmune diseases, Giron-Gonzalez et al reported no thromboses in participants receiving no prophylaxis (except during high-risk periods such as surgeries) (16).…”

Section: Discussionmentioning

confidence: 99%

“…At the time of the study design in 2000, based on a limited number of studies, we estimated that untreated, asymptomatic aPL-positive individuals would have a 1-5% risk of annual acute thrombosis (11)(12)(13). The APLASA study sample size calculation was based on the hypothesis that (1) are not included.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: A randomized, double‐blind, placebo‐controlled trial in asymptomatic antiphospholipid antibody–positive individuals

Erkan¹,

Harrison²,

Levy³

et al. 2007

Arthritis & Rheumatism

367

206

View full text Add to dashboard Cite

Objective. To determine the efficacy of a daily dose of 81 mg aspirin in primary thrombosis prevention in asymptomatic, persistently antiphospholipid antibody (aPL)-positive individuals (those with positive aPL but no vascular and/or pregnancy events).Methods. The Antiphospholipid Antibody Acetylsalicylic Acid (APLASA) study was a multicenter, randomized, double-blind, placebo-controlled clinical trial in which asymptomatic, persistently aPL-positive individuals were randomized to receive a daily dose of 81 mg of aspirin or placebo. In a separate observational and parallel study, asymptomatic, persistently aPL-positive individuals who were taking aspirin or declined randomization were followed up prospectively.Results. In the APLASA study, 98 individuals were randomized to receive aspirin or placebo (mean ؎ SD followup period 2.30 ؎ 0.95 years), of whom 48 received aspirin and 50 received placebo. In the observational study, 74 nonrandomized individuals were followed up prospectively (mean ؎ SD followup period 2.46 ؎ 0.76 years); 61 received aspirin and 13 did not. In the APLASA study, the acute thrombosis incidence rates were 2.75 per 100 patient-years for aspirin-treated subjects and 0 per 100 patient-years for the placebo-treated subjects (hazard ratio 1.04, 95% confidence interval 0.69-1.56) (P ‫؍‬ 0.83). Similarly, in the observational study, the acute thrombosis incidence rates were 2.70 per 100 patient-years for aspirin-treated subjects and 0 per 100 patient-years for those not treated with aspirin.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: A randomized, double‐blind, placebo‐controlled trial in asymptomatic antiphospholipid antibody–positive individuals

Erkan¹,

Harrison²,

Levy³

et al. 2007

Arthritis & Rheumatism

367

206

View full text Add to dashboard Cite

show abstract

“…A number of studies have previously demonstrated that aPL can increase the risk of thrombotic events, suggesting an important role for these autoantibodies in the pathogenesis of APS (28,29). However, their role in the development of lupus has largely remained unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Lupus patients who develop aPL have an increased risk of developing thrombocytopenia (range 11-40%, versus ϳ4-17% in aPL-negative SLE), hemolytic anemia (range 5-16% versus 2-8%), and symptoms traditionally thought of as being associated with APS rather than SLE, such as arterial or venous thrombosis and recurrent fetal loss (6)(7)(8)(9)(10)(28)(29)(30)(31). In our study, thrombocytopenia and hemolytic anemia were found to be significantly more common among aPL-positive patients, as was the risk of thrombotic events usually associated with APS.…”

Section: Discussionmentioning

confidence: 99%

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

McClain¹,

Arbuckle²,

Heinlen³

et al. 2004

Arthritis & Rheumatism

172

126

View full text Add to dashboard Cite

Objective. To determine whether antiphospholipid antibodies (aPL) occur before the diagnosis of systemic lupus erythematosus (SLE) and before initial clotting events, and whether their presence early in the disease course influences clinical outcome.Methods. Serum samples obtained from 130 lupus patients before and after SLE diagnosis were screened for IgG and IgM aPL using an anticardiolipin (aCL) enzyme-linked immunosorbent assay. Medical records of all patients were carefully reviewed for data on the time of onset of SLE features meeting clinical criteria and on disease manifestations.Results. Twenty-four patients (18.5%) were positive for IgG and/or IgM aCL prior to SLE diagnosis. Anticardiolipin antibodies appeared from 7.6 years prior to SLE diagnosis to within the same month as SLE diagnosis, with a mean onset occurring 3.0 years before SLE diagnosis. Additionally, aCL presence early in the disease process seemed to predict a more severe clinical outcome; these patients eventually met an average of 6.1 of the 11 classification criteria for SLE, compared with 4.9 criteria for other patients (P < 0.001). The early aCL-positive population also had more frequent renal disease, central nervous system disease, thrombocytopenia, and clotting events. In this population, aCL preceded initial thrombotic events by a mean of 3.1 years.Conclusion. Anticardiolipin antibodies in SLE patients tend to precede initial clotting events by several years. Furthermore, the presence of early, prediagnosis aPL seems to herald a more varied, severe clinical course with earlier onset in patients with SLE.

show abstract

Hypercoagulability Syndromes

Thomas¹

2001

Archives of Internal Medicine

127

View full text Add to dashboard Cite

Hypercoagulability can be defined as the tendency to have thrombosis as a result of certain inherited and/or acquired molecular defects. Clinical manifestations of hypercoagulability can be devastating and even lethal. In the past 20 years, the origin of most of these diverse hypercoagulability syndromes has been elucidated. Currently, hypercoagulability disorders can be correctly diagnosed in approximately 80% to 90% of patients. Defining the cause of hypercoagulability may determine the type and duration of treatment for the associated thrombosis. The discovery of an occult carcinoma allows for the possibility of early and possibly curative treatment. Finding a genetic defect in coagulation allows for testing of asymptomatic family members as well. The purpose of this review is to provide internists with a logical approach to the identification and treatment of hypercoagulability syndromes.

show abstract

Natural history and risk factors for thrombosis in 360 patients with antiphospholipid antibodies: A four-year prospective study from the italian registry

Cited by 403 publications

References 29 publications

Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: A randomized, double‐blind, placebo‐controlled trial in asymptomatic antiphospholipid antibody–positive individuals

Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: A randomized, double‐blind, placebo‐controlled trial in asymptomatic antiphospholipid antibody–positive individuals

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

Hypercoagulability Syndromes

Contact Info

Product

Resources

About