Objective. The present study was undertaken to longitudinally evaluate titers of antibodies against beta(2)-glycoprotein I (anti-beta(2)GPI) and domain 1 (anti-D1), to identify predictors of variations in anti-beta(2)GPI and anti-D1 titers, and to clarify whether antibody titer fluctuations predict thrombosis in a large international cohort of patients who were persistently positive for antiphospholipid antibodies (aPL) in the APS ACTION Registry.Methods. Patients with available blood samples from at least 4 time points (at baseline [year 1] and at years 2-4 of follow-up) were included. Detection of anti-beta(2)GPI and anti-D1 IgG antibodies was performed using chemiluminescence (BIO-FLASH; INOVA Diagnostics).Results. Among 230 patients in the study cohort, anti-D1 and anti-beta(2)GPI titers decreased significantly over time (P < 0.0001 and P = 0.010, respectively). After adjustment for age, sex, and number of positive aPL tests, we found that the fluctuations in anti-D1 and anti-beta(2)GPI titer levels were associated with treatment with hydroxychloroquine (HCQ) at each time point. Treatment with HCQ, but not immunosuppressive agents, was associated with 1.3-fold and 1.4-fold decreases in anti-D1 and anti-beta(2)GPI titers, respectively. Incident vascular events were associated with 1.9-fold and 2.1-fold increases in anti-D1 and anti-beta(2)GPI titers, respectively. Anti-D1 and anti-beta(2)GPI titers at the time of thrombosis were lower compared to titers at other time points. A 1.6-fold decrease in anti-D1 titers and a 2-fold decrease in anti-beta(2)GPI titers conferred odds ratios for incident thrombosis of 6.0 (95% confidence interval [95% CI] 0.62-59.3) and 9.4 (95% CI 1.1-80.2), respectively.Conclusion. Treatment with HCQ and incident vascular events in aPL-positive patients predicted significant anti-D1 and anti-beta(2)GPI titer fluctuations over time. Both anti-D1 and anti-beta(2)GPI titers decreased around the time of thrombosis, with potential clinical relevance.

Fluctuation of Anti–Domain 1 and Anti–β2‐Glycoprotein I Antibody Titers Over Time in Patients With Persistently Positive Antiphospholipid Antibodies / C.B. Chighizola, F. Pregnolato, D. Andrade, M. Tektonidou, V. Pengo, G. Ruiz‐irastorza, H.M. Belmont, M. Gerosa, P. Fortin, D.W. Branch, L. Andreoli, M.A. Petri, R. Cervera, J.S. Knight, R. Willis, M. Efthymiou, H. Cohen, D. Erkan, M.L. Bertolaccini. - In: ARTHRITIS & RHEUMATOLOGY. - ISSN 2326-5191. - 75:6(2023 Jun), pp. 984-995. [10.1002/art.42459]

Fluctuation of Anti–Domain 1 and Anti–β2‐Glycoprotein I Antibody Titers Over Time in Patients With Persistently Positive Antiphospholipid Antibodies

C.B. Chighizola
Primo
;
M. Gerosa;
2023

Abstract

Objective. The present study was undertaken to longitudinally evaluate titers of antibodies against beta(2)-glycoprotein I (anti-beta(2)GPI) and domain 1 (anti-D1), to identify predictors of variations in anti-beta(2)GPI and anti-D1 titers, and to clarify whether antibody titer fluctuations predict thrombosis in a large international cohort of patients who were persistently positive for antiphospholipid antibodies (aPL) in the APS ACTION Registry.Methods. Patients with available blood samples from at least 4 time points (at baseline [year 1] and at years 2-4 of follow-up) were included. Detection of anti-beta(2)GPI and anti-D1 IgG antibodies was performed using chemiluminescence (BIO-FLASH; INOVA Diagnostics).Results. Among 230 patients in the study cohort, anti-D1 and anti-beta(2)GPI titers decreased significantly over time (P < 0.0001 and P = 0.010, respectively). After adjustment for age, sex, and number of positive aPL tests, we found that the fluctuations in anti-D1 and anti-beta(2)GPI titer levels were associated with treatment with hydroxychloroquine (HCQ) at each time point. Treatment with HCQ, but not immunosuppressive agents, was associated with 1.3-fold and 1.4-fold decreases in anti-D1 and anti-beta(2)GPI titers, respectively. Incident vascular events were associated with 1.9-fold and 2.1-fold increases in anti-D1 and anti-beta(2)GPI titers, respectively. Anti-D1 and anti-beta(2)GPI titers at the time of thrombosis were lower compared to titers at other time points. A 1.6-fold decrease in anti-D1 titers and a 2-fold decrease in anti-beta(2)GPI titers conferred odds ratios for incident thrombosis of 6.0 (95% confidence interval [95% CI] 0.62-59.3) and 9.4 (95% CI 1.1-80.2), respectively.Conclusion. Treatment with HCQ and incident vascular events in aPL-positive patients predicted significant anti-D1 and anti-beta(2)GPI titer fluctuations over time. Both anti-D1 and anti-beta(2)GPI titers decreased around the time of thrombosis, with potential clinical relevance.
Settore MED/16 - Reumatologia
giu-2023
27-gen-2023
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1032220
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