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86 Do all antiphospholipid antibodies confer the same risk for major organ involvement in systemic lupus erythematosus patients?
  1. Leyre Riancho-Zarrabeitia1,
  2. Víctor M Martínez-Taboada2,
  3. Iñigo Rua Figueroa3,
  4. Fernando Alonso4,
  5. Maria Galindo Izquierdo5,
  6. Juan Ovalles-Bonilla6,
  7. Alejandro Olivé-Marqués7,
  8. Antonio Fernandez Nebro8,
  9. Jaime Calvo9,
  10. Javier Narváez-García10,
  11. Eva Tomero Muriel11,
  12. Esther Uriarte Isacelaya12,
  13. Carlos Galisteo13,
  14. Víctor Quevedo Vila14,
  15. Enrique Raya15,
  16. Javier Narváez-García16,
  17. Lorena Expósito17,
  18. José A Hernández-Beriaín18,
  19. Loreto Horcada19 and
  20. Jose Maria Pego Reigosa20
  1. 1Hospital Sierrallana
  2. 2Hospital Universitario Marqués de Valdecilla
  3. 3Hospital de Gran Canaria dr. Negrín
  4. 4Sociedad Española de Reumatología
  5. 5Hospital Universitario 12 De Octubre
  6. 6Hospital General Universitario Gregorio Marañón
  7. 7Hospital German Trias i Pujol
  8. 8UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA) Hospital Regional Universitario de Málaga, Spain
  9. 9Hospital Universitario Araba
  10. 10Hospital de Bellvitge
  11. 11Hospital De La Princesa
  12. 12Hospital De Donostia
  13. 13Hospital Parc Taulí. Sabadel
  14. 14Hospital Monforte
  15. 15San Cecilio Hospital, Granada (Spain)
  16. 16Bellvitge University Hospital, Barcelona
  17. 17Hospital Universitario de Canarias
  18. 18Hospital Insular De Gran Canaria
  19. 19Complejo Hospitalario de Navarra
  20. 20Complexo hospitalario Universitario Vigo


Background Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in systemic lupus erythematosus (SLE) patients. Our aim is to investigate the association between the different aPL and SLE manifestations as well as to elucidate the influence of the load of antibodies.

Methods Patients from the RELESSER-T registry were included. RELESSER-T is a multicenter, hospital-based registry, with retrospective cross-sectional collection of data from a large representative sample of adult non-selected patients with SLE attending Spanish rheumatology services from the public national health system.

Results Out of a total of 3651 SLE patients, 1368 were positive for aPL (44.9% of patients were positive for anticardiolipin (aCL) antibodies, 27.3% for anti b2glycoprotein I (aB2GPI) and 24% for lupus anticoagulant (LA)). Regarding the load of antibodies, 20.6%, 12.1% and 4.8% were positive for one, two and three antibodies, respectively. The association between the different aPL, the number of positive antibodies and antiphospholipid syndrome related manifestations is showed in table 1. Overall, all types of aPL were associated with classic APS manifestations, although LA, IgG isotypes, and patients with more than one aPL display a higher risk to develop clinical APS.

Regarding specific lupus manifestations, all aPL types showed a negative association with cutaneous manifestations, and was also significantly associated with the load of autoantibodies (p<0.001). LA and aCL were associated with an increased risk of cardiac, respiratory and neuropsychiatric manifestations (p<0.001). Furthermore, LA was also associated with an increased risk of renal disease (p<0.001). aCL IgG was associated with a higher risk of specific lupus manifestations compared with aCL IgM. Interestingly, aB2GP IgG were only associated with an increased risk of seizures (p<0.001). When evaluating the influence of the load of antibodies, we found that the risk of neuropsychiatric manifestations (p<0.001), as well as the cardiac (p=0.003), and pulmonary manifestations (p=0.001), significantly increased with a higher number of positive antibodies. Inversely, the risk of cutaneous symptoms decreased while the number of positive antibodies increased (OR 0.89, 95% CI 0.82–0.96, p=0.003).

Abstract 86 Table 1

Association between the different aPL and the number of positive antibodies and APS related features

Conclusions The present study in a large SLE cohort confirm than there is a hierarchy for aPL and the risk of APS and lupus manifestations. aCL, and especially LA, confer a higher risk for major organ involvement in SLE patients. IgG isotypes and the load of aPL antibodies confer a higher risk for clinical APS and major lupus manifestations.

Funding Source(s): None

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