TY - JOUR T1 - Dr. Vlachoyiannopoulos replies JF - The Journal of Rheumatology JO - J Rheumatol SP - 90 LP - 90 DO - 10.3899/jrheum.120976 VL - 40 IS - 1 AU - PANAYIOTIS G. VLACHOYIANNOPOULOS Y1 - 2013/01/01 UR - http://www.jrheum.org/content/40/1/90.1.abstract N2 - To the Editor:We read with interest the comments of Drs. Barbhaiya and Erkan1 on our work published in The Journal2. The authors raised 2 important issues. The first was that as time passes, a great deal of organ damage is accumulated in patients with antiphospholipid syndrome (APS), significantly affecting their quality of life. We all agree with this, whichever way we quantify this damage. For instance, Erkan, et al in a previous report counted in a simple and informative way the events leading to disability3, to prove that accumulated damage characterizes the progression of APS. When, however, we have to evaluate large patient cohorts for a long time, a damage index offers … ER -