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Kathlin Ambrose, 12 Jun 2015
An expert consensus has developed evidence-based recommendations, which aims to provide crucial guidance to support family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS).

Thrombotic recurrence, organ damage likely in patients with primary antiphospholipid syndrome

17 Aug 2017

A large number of patients face new thrombotic events and organ damage in spite of therapy, while evolution toward connective tissue disease (CTD) is infrequent, according to a recent study.

Researchers retrospectively reviewed medical records of patients with primary antiphospholipid syndrome (PAPS) followed in six centres for ≥15 years to assess the long-term frequency of thrombotic recurrences, obstetrical complications, organ damage, severe comorbidities and evolution toward CTD in PAPS.

A total of 115 patients were analysed (mean age at diagnosis 33 years; 88 percent women) and followed between 1983 and 2014.

There were 50 patients (44 percent) who had at least a thrombotic event for a total of 75 events and an annual incidence of 3.5 percent during a median follow-up of 18 years (range, 15 to 30 years). Those with previous thrombotic history experienced more frequent thromboses (p=0.002).

Six patients (5 percent) had a catastrophic antiphospholipid syndrome. Oral anticoagulation did not appear to protect patients with thrombotic onset against recurrences (p=0.26).

Of the 87 pregnancies in 52 women, 78 percent were successful. Functional damage occurred in 29 percent of patients. Patients with a thrombotic history (p=0.004) were likely to accrue damage, which was also significantly associated with arterial events (p<0.001), especially stroke, but not with demographics, serology or treatment.

A total of 14 major bleeding episodes were recorded in 18 patients who received anticoagulants. Severe infections affected six patients (5 percent), with one fatality. Eight patients (7 percent) had a diagnosis of a solid cancer.

In total, 16 patients (14 percent) developed an autoimmune disease and 13 (11 percent) a full-blown picture of CTD, according to researchers.

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Most Read Articles
07 Mar 2018
The use of trabecular bone score (TBS) may be helpful in evaluating osteoporosis in ankylosing spondylitis (AS), as it is associated with the erythrocyte sedimentation rate (ESR) and severity of sacroiliitis in young male patients with AS, suggests a recent study.
Kathlin Ambrose, 12 Jun 2015
An expert consensus has developed evidence-based recommendations, which aims to provide crucial guidance to support family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS).