The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Workforce
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Advancements in Diagnosis, Treatment for Antiphospholipid Syndrome

Advancements in Diagnosis, Treatment for Antiphospholipid Syndrome

July 14, 2017 • By Lara C. Pullen, PhD

  • Tweet
  • Email
Print-Friendly Version / Save PDF
Marcelo Ricardo Daros/shutterstock.com

Marcelo Ricardo Daros/shutterstock.com

CHICAGO—Doruk Erkan, MD, MPH, a rheumatologist at the Hospital for Special Surgery and Weill Cornell Medicine in New York City, described recent developments in the field of antiphospholipid syndrome (APS) to the rheumatologists gathered for the ACR’s State-of-the-Art Clinical Symposium in April.

You Might Also Like
  • ACR/ARHP Annual Meeting 2012: Tips to Diagnose and Treat Catastrophic Antiphospholipid Syndrome (CAPS)
  • New Assays May Help in the Diagnosis & Management of Antiphospholipid Syndrome
  • Antiphospholipid Syndrome
Explore This Issue
July 2017
Also By This Author
  • Carpal Tunnel Syndrome: Is Post-Surgical Rehabilitation Helpful?

He introduced APS as a “field with limited data and lots of controversies,” although, he added that recently a significant amount of collaborative effort has been made to advance the field. For example, he discussed an international multidisciplinary effort underway to develop new APS classification criteria. The new criteria are being created using methodology endorsed by the ACR and European League Against Rheumatism (EULAR). Dr. Erkan said he hopes the APS classification criteria will be updated in the next few years.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Thrombosis Risk in aPL-Positive Patients

In addition, experts are creating improved risk calculation/stratification protocols for patients who test positive for antiphospholipid antibodies (aPL). This is important because the clinical manifestations of aPL occur on a spectrum and not every positive aPL result is clinically significant. Likewise, thrombosis is multifactorial, and many factors in addition to aPL can influence the thrombosis risk in aPL-positive patients.

So the question becomes: What is a clinically significant aPL profile? The most basic answer to this question is that, although low-titer anti-cardiolipin antibody (aCL) or anti-β2-glycoprotein-I (aβ2GPI) levels during infections are common, persistently elevated aPL is noteworthy. Thus, aCL or aβ2GPI titers that are less than 20 U are rarely clinically significant, but titers that are moderate to high (≥ 40 U) and/or positive lupus anticoagulant (LA) tests are associated with an increased risk of thrombosis.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

In particular, the report from the 14th International Congress on Antiphospholipid Antibodies Task Force published in Autoimmunity Reviews in 2014 described APS laboratory diagnostic and trends. It stated that “aPL should not only be considered as diagnostic markers, but also as risk factors for clinical events.”1 The hope is that aPL and other risk factors can ultimately be compiled into a calculator that can be used to predict the risk of thrombosis.

One such effort to calculate thrombosis risk using aPL profile and selected cardiovascular disease risk factors is the Global APS Score (GAPSS), which was verified in four steps.2 In the first step, patients with systemic lupus erythematosus (SLE) were assigned weighted points based on risk factors identified by multivariate analysis. The researchers noted that the scoring protocol awarded higher scores to patients with thrombosis and pregnancy morbidity. In the second step, the scores were validated in patients with SLE. The third step involved a prospective assessment of patients with SLE; during this step, the researchers found that those with more than a three-point increase during the follow-up were most reliably at increased risk for vascular events. Finally, in step four, researchers assessed patients with primary APS (PAPS) and found a higher score in patients with thrombosis relative to those with pregnancy morbidity.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Meeting Reports, Systemic Inflammatory Syndromes Tagged With: 2017 State of the Art Clinical Symposium, AC&R, American College of Rheumatology, Antiphospholipid Syndrome, Classification Criteria, Diagnosis, prevention, Research, rheumatology, risk, thrombosis, Treatment, updateIssue: July 2017

You Might Also Like:
  • ACR/ARHP Annual Meeting 2012: Tips to Diagnose and Treat Catastrophic Antiphospholipid Syndrome (CAPS)
  • New Assays May Help in the Diagnosis & Management of Antiphospholipid Syndrome
  • Antiphospholipid Syndrome
  • Antiphospholipid Antibody Syndrome: Much Remains to be Learned

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.