TY - JOUR T1 - Antiphospholipid Antibody Profile Stability Over Time: Prospective Results from APS ACTION Clinical Database and Repository JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.200513 SP - jrheum.200513 AU - Elena Gkrouzman AU - Ecem Sevim AU - Jackie Finik AU - Danieli Andrade AU - Vittorio Pengo AU - Savino Sciascia AU - Maria G. Tektonidou AU - Amaia Ugarte AU - Cecilia B. Chighizola AU - H. Michael Belmont AU - Chary Lopez-Pedrera AU - Lanlan Ji AU - Paul Fortin AU - Maria Efthymiou AU - Guilherme Ramires de Jesus AU - D. Ware Branch AU - Cecilia Nalli AU - Michelle Petri AU - Esther Rodriguez AU - Ricard Cervera AU - Jason S. Knight AU - Tatsuya Atsumi AU - Rohan Willis AU - Maria Laura Bertolaccini AU - Hannah Cohen AU - Jacob Rand AU - Doruk Erkan Y1 - 2020/09/01 UR - http://www.jrheum.org/content/early/2020/08/24/jrheum.200513.abstract N2 - Objective APS ACTION Registry studies long-term outcomes in persistently antiphospholipid antibody (aPL)-positive patients. Our primary objective was to determine whether clinically meaningful aPL profiles at baseline remain stable over time. Our secondary objectives were to determine a) whether baseline characteristics differ between patients with stable and unstable aPL profiles, and b) predictors of unstable aPL profiles over time. Methods Clinically meaningful aPL profile was defined as positive lupus anticoagulant (LA) test and/or anticardiolipin (aCL)/anti-β2 glycoprotein-I (aβ2GPI) IgG/M ≥40 U. Stable aPL profile was defined as a clinically meaningful aPL profile in at least two-thirds of follow-up measurements. Generalized linear mixed models with logit link were used for primary objective analysis. Results Of 472 patients with clinically meaningful aPL profile at baseline (median follow up: 5.1 years), 366/472 (78%) patients had stable aPL profiles over time, 54 (11%) unstable; and 52 (11%) inconclusive. Time did not significantly affect odds of maintaining a clinically meaningful aPL profile at follow-up in univariate (p=0.906) and multivariable analysis (p=0.790). Baseline triple aPL positivity decreased (Odds Ratio [OR] 0.25, 95% Confidence Interval [CI] 0.10-0.64, p=0.004) and isolated LA test positivity increased (OR 3.3, 95% CI 1.53-7.13, p=0.002) the odds of an unstable aPL profile over time. Conclusion Approximately 80% of our international cohort patients with clinically meaningful aPL profile at baseline maintain such at a median follow-up of five years; triple aPL-positivity increase the odds of a stable aPL profile. These results will guide future validation studies of stored blood samples through APS ACTION Core Laboratories. ER -