Validity of the global anti-phospholipid syndrome score to predict thrombosis: a prospective multicentre cohort study.

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Date publication

juillet 2015

Auteurs

Membres identifiés du Cancéropôle Est :
Pr GUILLEMIN Francis, Dr RAT Anne-Christine


Tous les auteurs :
Zuily S, de Laat B, Mohamed S, Kelchtermans H, Shums Z, Albesa R, Norman GL, Lamboux-Matthieu C, Rat AC, Ninet J, Magy-Bertrand N, Pasquali JL, Lambert M, Lorcerie B, Kaminsky P, Guillemin F, Regnault V, Wahl D

Résumé

OBJECTIVE: To investigate the validity of the global APS score (GAPSS) to predict thrombosis in patients with autoimmune diseases. METHODS: This prospective cohort study included consecutive patients with aPL or SLE. aPL, aPS-PT and GAPSS were determined. A Cox proportional hazards model assessed the validity of GAPSS and identified other potential independent predictors of thrombosis. RESULTS: One hundred and thirty-seven patients [43.5 (s.d. 15.4) years old; 107 women] were followed up for a mean duration of 43.1 (s.d. 20.7) months. Mean GAPSS was significantly higher in patients who experienced a thrombotic event compared with those without [10.88 (s.d. 5.06) vs 8.15 (s.d. 5.31), respectively, P = 0.038]. In univariate analysis, age [hazard ratio (HR) = 1.04 (95% CI 1.01, 1.08)] and GAPSS above 16 [HR = 6.86 (95% CI 1.90, 24.77)] were each significantly associated with thrombosis during follow-up, while history of arterial thrombosis [HR = 2.61 (95% CI 0.87, 7.82)] failed to reach significance. Among aPL assays, IgG aPS/PT-a component of the GAPSS-was significantly associated with thrombosis [HR = 2.95 (95% CI 1.02, 8.51)]. In multivariate analysis, GAPSS above 16 remained the only significant predictor of thrombosis [HR = 6.17 (95% CI 1.70, 22.40)]. CONCLUSION: This first external validation study confirmed that GAPSS can predict thrombosis in patients with aPL and associated autoimmune diseases.

Référence

Rheumatology (Oxford). 2015 Jul 10. pii: kev238.