Validation of the adjusted global antiphospholipid syndrome score in a single centre cohort of APS patients from Turkey

Uludag, Omer; Bektaş, Murat; Çene, Erhan; Sezer, Murat; Şahinkaya, Yasemin; Gül, Ahmet; İnanç, Murat; Öçal, Lale; Artim‐Esen, Bahar

doi:10.1007/s11239-020-02195-4

Cited by 8 publications

(13 citation statements)

References 45 publications

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“…16 Afterwards, the predictive ability of the aGAPSS/GAPSS was validated for APS patients in different retrospective cohort studies. 19,21,24,25 This was further confirmed in a recent systematic review. 20 Moreover, the aGAPSS/GAPSS has also been proposed to identify patients at higher risk of developing any clinical manifestations of APS, including pregnancy morbidity.…”

Section: Discussionsupporting

confidence: 60%

“…The association between CV risk factors and more than one aPL positivity as independent risk factors was demonstrated in similar studies. 6,19,21 In those studies, the synergistic effect between these independent risk factors was also reflected in a high GAPSS/aGAPSS. 6,19,21…”

Section: Discussionmentioning

confidence: 90%

“…9,11,29-32 In addition, our findings are reinforced by the observations of ÖmerUludağ et al 16 who showed that CV risk factors, especially arterial hypertension and hyperlipidaemia, had a significantly lower contribution to the aGAPSS in pregnancy morbidity patients. 19…”

Section: Discussionmentioning

confidence: 99%

“…The cumulative aGAPSS was calculated for each patient, as previously reported. 16,19 Currently, there is no clear cut-off point for the aGAPSS since values may differ among groups. 15,20,21 According to the results obtained from Savino et al, in a systematic review, the cumulative mean aGAPSS associated with any thrombotic manifestation was 7.6.…”

Section: Methodsmentioning

confidence: 99%

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Clinical and therapeutic value of the adjusted Global Antiphospholipid Syndrome Score in primary obstetric antiphospholipid syndrome

¨perez

Bélizna

Aranda

et al. 2022

Lupus

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Objectives (1) To assess the clinical utility of the adjusted global antiphospholipid syndrome score (aGAPSS) to predict new obstetric events during follow-up in primary obstetric antiphospholipid syndrome (POAPS) patients under standard-of-care treatment (SC) based on the use of low-dose aspirin (LDA) + heparin and (2) to study the risk of a first thrombotic event and to evaluate whether stratification according to this score could help to identify POAPS patients who would benefit from long-term thromboprophylaxis. Methods This is a retrospective, multicentre study. 169 women with POAPS were evaluated for the presence of a new obstetric event and/or a first thrombotic event during follow-up [time period: 2008–2020, median: 7 years (6–12 years)]. The outcomes of 107 pregnancies from these POAPS patients with SC were studied to evaluate relapses. Simple and multivariable logistic regression analyses were performed. Results Regarding obstetric morbidity, only triple positivity for antiphospholipid antibodies (aPLs) [OR = 8.462 (95% CI: 2.732–26.210); p < 0.0001] was found to be a strong risk factor independently associated with treatment failure. On the other hand, triple positivity for aPLs [OR=10.44 (95% CI: 2.161–50.469), p = 0.004] and an aGAPSS ≥7 [OR = 1.621 (95% CI: 1.198–2.193), p = 0.002] were independent risk factors associated with a first thrombotic event. LDA was marginally associated with a decrease in the risk of thrombosis only in patients with aGAPSS ≥ 7 ( p = 0.048). Conclusion aGAPSS appears to be useful in predicting the occurrence of a first thrombotic event in POAPS patients, and these stratification of patients could be helpful in selecting patients who would benefit from thromboprophylaxis with LDA.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Clinical and therapeutic value of the adjusted Global Antiphospholipid Syndrome Score in primary obstetric antiphospholipid syndrome

¨perez

Bélizna

Aranda

et al. 2022

Lupus

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“…The APL-score [12], the GAPPS score [11], and more recently, the EUREKA algorithm [10] have attempted to stratify the risk of developing clinical manifestations in patients with aPL. Whereas the first two scores have been mainly validated in APS with thrombotic manifestations [13][14][15][16][17][18][19], the EUREKA algorithm has been developed mainly for obstetric manifestations and has not yet been validated in external cohorts [10]. Furthermore, most of the studies that analyzed the impact of these scores on pregnancy outcomes have been done in cohorts that mostly included patients with various autoimmune diseases, especially SLE [13,20,21].…”

Section: Introductionmentioning

confidence: 99%

Does Adjusted Global Antiphospholipid Syndrome Score (aGAPSS) Predict the Obstetric Outcome in Antiphospholipid Antibody Carriers? A Single-Center Study

Barrio-Longarela

Martínez‐Taboada

Blanco-Olavarri

et al. 2021

Clinic Rev Allerg Immunol

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The adjusted Global Antiphospholipid Syndrome (APS) Score (aGAPSS) is a tool proposed to quantify the risk for antiphospholipid antibody (aPL)-related clinical manifestations. However, aGAPSS has been validated mainly for thrombotic events and studies on APS-related obstetric manifestations are scarce. Furthermore, the majority of them included patients with positive aPL and different autoimmune diseases. Here, we assess the utility of aGAPSS to predict the response to treatment in aPL carriers without other autoimmune disorders. One-hundred and thirty-seven women with aPL ever pregnant were included. Sixty-five meet the APS classification criteria, 61 had APS-related obstetric manifestations, and 11 were asymptomatic carriers. The patients’ aGAPSS risk was grouped as low (< 6, N = 73), medium (6–11, N = 40), and high risk (≥ 12, N = 24). Since vascular risk factors included in the aGAPSS were infrequent in this population (< 10%), the aGAPSS score was mainly determined by the aPL profile. Overall, the live birth rate was 75%, and 37.2% of the patients had at least one adverse pregnancy outcome (APO). When considering patients according to the aGAPSS (high, medium, and low risk), no significant differences were found for pregnancy loss (29.2%, 25%, and 21.9%) or APO (33.3%, 47.5%, and 32.9%). In the present study, including aPL carriers without other autoimmune diseases, aGAPSS is not a valuable tool to identify patients at risk for obstetric complications despite treatment. In these patients with gestational desire, in addition to the aPL profile, other pregnancy-specific factors, such as age or previous obstetric history, should be considered.

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Antiphospholipid Syndrome: Thrombotic and Vascular Complications

Windisch,

Ash,

Frishman

2023

Cardiology in Review

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Antiphospholipid syndrome is a rare, autoimmune thrombophilia defined by vascular thrombosis and pregnancy morbidity, in the setting of documented persistent antiphospholipid antibodies including the lupus anticoagulant, anticardiolipin antibodies, or anti-β2 glycoprotein I antibodies. The presence of antiphospholipid antibodies can be completely asymptomatic, or they can lead to clinical manifestations as severe as catastrophic antiphospholipid syndrome, which involves widespread coagulopathy over a very short period of time. The degree of risk associated with antiphospholipid syndrome depends on the characteristics of the antiphospholipid antibody profile and on the presence of additional thrombotic risk factors. The current standard treatment for unprovoked thrombosis is long-term warfarin. Treatment to prevent recurrent obstetric complications is low-dose aspirin and prophylactic heparin in pregnant patients. The use of direct oral anticoagulants in patients with antiphospholipid syndrome is still being debated. Their use is generally contraindicated, especially in high-risk patients, such as those with all 3 antiphospholipid antibodies present, but they may potentially be of some use in some low-risk patients.

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Validation of the adjusted global antiphospholipid syndrome score in a single centre cohort of APS patients from Turkey

Cited by 8 publications

References 45 publications

Clinical and therapeutic value of the adjusted Global Antiphospholipid Syndrome Score in primary obstetric antiphospholipid syndrome

Clinical and therapeutic value of the adjusted Global Antiphospholipid Syndrome Score in primary obstetric antiphospholipid syndrome

Does Adjusted Global Antiphospholipid Syndrome Score (aGAPSS) Predict the Obstetric Outcome in Antiphospholipid Antibody Carriers? A Single-Center Study

Antiphospholipid Syndrome: Thrombotic and Vascular Complications

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