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1. POS1415 MATERNAL AND FETAL OUTCOMES OF PROSPECTIVELY FOLLOWED PREGNANCIES IN SYSTEMIC SCLEROSIS: THE EXPERIENCE OF A MULTIDISCIPLINARY PREGNANCY CLINIC IN 2008-2023

Author

Moschetti, L., primary, Andreoli, L., additional, Semeraro, P., additional, Pedretti, E., additional, Crisafulli, F., additional, Ramazzotto, F., additional, Nalli, C., additional, Lini, D., additional, Filippini, M., additional, Zanardini, C., additional, Fredi, M., additional, Taglietti, M., additional, Franceschini, F., additional, Tincani, A., additional, Zatti, S., additional, Airo’, P., additional, and Lazzaroni, M. G., additional

Published
2024
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2. POS0895 FAMILY PLANNING IN WOMEN AFFECTED BY RHEUMATOLOGICAL DISEASES: REAL-LIFE DATA FROM ITALY

Author

Carrea, G., primary, Gerosa, M., additional, Mosca, M., additional, Padovan, M., additional, Paolino, S., additional, Anelli, M. G., additional, Ramonda, R., additional, Nalli, C., additional, Rovere-Querini, P., additional, Bellis, E., additional, D’angelo, S., additional, Fusaro, E., additional, Chimenti, M. S., additional, Santo, L., additional, Gabini, M., additional, Pazzola, G., additional, Serale, F., additional, Montecucco, C., additional, Conti, F., additional, and Caporali, R. F., additional

Published
2024
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7. Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospective Italian P-RHEUM.it study

Author

Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, Tincani, Angela, Andreoli, L, Gerardi, M, Gerosa, M, Rozza, D, Crisafulli, F, Erra, R, Lini, D, Trespidi, L, Padovan, M, Ruffilli, F, Serale, F, Cuomo, G, Raffeiner, B, Semeraro, P, Tani, C, Chimenti, M, Conigliaro, P, Hoxha, A, Nalli, C, Fredi, M, Lazzaroni, M, Filippini, M, Taglietti, M, Franceschini, F, Zatti, S, Loardi, C, Orabona, R, Ramazzotto, F, Zanardini, C, Fontana, G, Gozzoli, G, Barison, C, Bizioli, P, Caporali, R, Carrea, G, Ossola, M, Maranini, B, Silvagni, E, Govoni, M, Morano, D, Verteramo, R, Doria, A, Del Ross, T, Favaro, M, Calligaro, A, Tonello, M, Larosa, M, Zen, M, Zambon, A, Mosca, M, Zucchi, D, Elefante, E, Gori, S, Iannone, F, Anelli, M, Lavista, M, Abbruzzese, A, Fasano, C, D'Angelo, S, Cutro, M, Picerno, V, Carbone, T, Padula, A, Rovere-Querini, P, Canti, V, De Lorenzo, R, Cavallo, L, Ramoni, V, Montecucco, C, Codullo, V, Milanesi, A, Pazzola, G, Comitini, G, Marvisi, C, Salvarani, C, Epis, O, Benedetti, S, Di Raimondo, G, Gagliardi, C, Lomater, C, Crepaldi, G, Bellis, E, Bellisai, F, Garcia Gonzalez, E, Pata, A, Zerbinati, M, Urban, M, Mattioli, I, Iuliano, A, Sebastiani, G, Brucato, A, Bizzi, E, Cutolo, M, Santo, L, Tonetta, S, Landolfi, G, Carrara, G, Bortoluzzi, A, Scirè, C, Tincani, A, Andreoli, Laura, Gerardi, Maria Chiara, Gerosa, Maria, Rozza, Davide, Crisafulli, Francesca, Erra, Roberta, Lini, Daniele, Trespidi, Laura, Padovan, Melissa, Ruffilli, Francesca, Serale, Francesca, Cuomo, Giovanna, Raffeiner, Bernd, Semeraro, Paolo, Tani, Chiara, Chimenti, Maria Sole, Conigliaro, Paola, Hoxha, Ariela, Nalli, Cecilia, Fredi, Micaela, Lazzaroni, Maria Grazia, Filippini, Matteo, Taglietti, Marco, Franceschini, Franco, Zatti, Sonia, Loardi, Chiara, Orabona, Rossana, Ramazzotto, Francesca, Zanardini, Cristina, Fontana, Giulia, Gozzoli, Giorgia, Barison, Claudia, Bizioli, Paola, Caporali, Roberto Felice, Carrea, Giulia, Ossola, Manuela Wally, Maranini, Beatrice, Silvagni, Ettore, Govoni, Marcello, Morano, Danila, Verteramo, Rosita, Doria, Andrea, Del Ross, Teresa, Favaro, Maria, Calligaro, Antonia, Tonello, Marta, Larosa, Maddalena, Zen, Margherita, Zambon, Alessandra, Mosca, Marta, Zucchi, Dina, Elefante, Elena, Gori, Sabrina, Iannone, Florenzo, Anelli, Maria Grazia, Lavista, Marlea, Abbruzzese, Anna, Fasano, Carlo Giuseppe, D'Angelo, Salvatore, Cutro, Maria Stefania, Picerno, Valentina, Carbone, Teresa, Padula, Angela Anna, Rovere-Querini, Patrizia, Canti, Valentina, De Lorenzo, Rebecca, Cavallo, Ludovica, Ramoni, Véronique, Montecucco, Carlomaurizio, Codullo, Veronica, Milanesi, Alessandra, Pazzola, Giulia, Comitini, Giuseppina, Marvisi, Chiara, Salvarani, Carlo, Epis, Oscar Massimiliano, Benedetti, Sara, Di Raimondo, Giuseppina, Gagliardi, Clizia, Lomater, Claudia, Crepaldi, Gloria, Bellis, Elisa, Bellisai, Francesca, Garcia Gonzalez, Estrella, Pata, Anna Paola, Zerbinati, Martina, Urban, Maria Letizia, Mattioli, Irene, Iuliano, Annamaria, Sebastiani, Giandomenico, Brucato, Antonio Luca, Bizzi, Emanuele, Cutolo, Maurizio, Santo, Leonardo, Tonetta, Sara, Landolfi, Gianpiero, Carrara, Greta, Bortoluzzi, Alessandra, Scirè, Carlo Alberto, and Tincani, Angela

Abstract

Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures.

Published
2024

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Author

Chighizola, C.B. Pregnolato, F. Andrade, D. Tektonidou, M. Pengo, V. Ruiz-Irastorza, G. Belmont, H.M. Gerosa, M. Fortin, P. Branch, D.W. Andreoli, L. Petri, M.A. Cervera, R. Knight, J.S. Willis, R. Efthymiou, M. Cohen, H. Erkan, D. Bertolaccini, M.L. Pons-Estel, G. Giannakopoulos, B. Krilis, S. de Jesus, G. Levy, R. Signorelli, F. Andrade, D. Balbi, G. Clarke, A.E. Skeith, L. Fortin, P.R. Ji, L. Zhang, Z. Yang, C. Shi, H. Zuily, S. Wahl, D. Tektonidou, M.G. Nalli, C. Andreoli, L. Tincani, A. Chighizola, C.B. Gerosa, M. Meroni, P.L. Pengo, V. Cheng, C. Pazzola, G. Sciascia, S. Foddai, S. Radin, M. Davis, S. Amengual, O. Atsumi, T. Uthman, I. Limper, M. de Groot, P. Ruiz-Irastorza, G. Ugarte, A. Rodriguez-Pinto, I. Cervera, R. Barilaro, G. Ríos-Garcés, R. Pardos-Gea, J. Almaraz, E.R. Cuadrado, M.J. Zamorano, M.A.A. Lopez-Pedrera, C. Artim-Esen, B. Inanc, M. Bertolaccini, M.L. Cohen, H. Efthymiou, M. Khamashta, M. Mackie, I. Sanna, G. Knight, J. Zuo, Y. Petri, M. Leaf, R.K. Roubey, R. Ortel, T. Gonzalez, E. Willis, R. Kello, N. Belmont, M. Levine, S. Rand, J. Barbhaiya, M. Erkan, D. Salmon, J. Lockshin, M. Duarte Garcia, A.A. Branch, D.W. Antiphospholipid Syndrome Alliance for Clinical Trials International Networking (APS ACTION) and Chighizola, C.B. Pregnolato, F. Andrade, D. Tektonidou, M. Pengo, V. Ruiz-Irastorza, G. Belmont, H.M. Gerosa, M. Fortin, P. Branch, D.W. Andreoli, L. Petri, M.A. Cervera, R. Knight, J.S. Willis, R. Efthymiou, M. Cohen, H. Erkan, D. Bertolaccini, M.L. Pons-Estel, G. Giannakopoulos, B. Krilis, S. de Jesus, G. Levy, R. Signorelli, F. Andrade, D. Balbi, G. Clarke, A.E. Skeith, L. Fortin, P.R. Ji, L. Zhang, Z. Yang, C. Shi, H. Zuily, S. Wahl, D. Tektonidou, M.G. Nalli, C. Andreoli, L. Tincani, A. Chighizola, C.B. Gerosa, M. Meroni, P.L. Pengo, V. Cheng, C. Pazzola, G. Sciascia, S. Foddai, S. Radin, M. Davis, S. Amengual, O. Atsumi, T. Uthman, I. Limper, M. de Groot, P. Ruiz-Irastorza, G. Ugarte, A. Rodriguez-Pinto, I. Cervera, R. Barilaro, G. Ríos-Garcés, R. Pardos-Gea, J. Almaraz, E.R. Cuadrado, M.J. Zamorano, M.A.A. Lopez-Pedrera, C. Artim-Esen, B. Inanc, M. Bertolaccini, M.L. Cohen, H. Efthymiou, M. Khamashta, M. Mackie, I. Sanna, G. Knight, J. Zuo, Y. Petri, M. Leaf, R.K. Roubey, R. Ortel, T. Gonzalez, E. Willis, R. Kello, N. Belmont, M. Levine, S. Rand, J. Barbhaiya, M. Erkan, D. Salmon, J. Lockshin, M. Duarte Garcia, A.A. Branch, D.W. Antiphospholipid Syndrome Alliance for Clinical Trials International Networking (APS ACTION)

Published
2023

9. Anti–Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody–Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository

Author

Zuo, Y. Navaz, S. Tsodikov, A. Kmetova, K. Kluge, L. Ambati, A. Hoy, C.K. Yalavarthi, S. de Andrade, D. Tektonidou, M.G. Sciascia, S. Pengo, V. Ruiz-Irastorza, G. Belmont, H.M. Gerosa, M. Fortin, P.R. de Jesus, G.R. Branch, D.W. Andreoli, L. Rodriguez-Almaraz, E. Petri, M. Cervera, R. Willis, R. Karp, D.R. Li, Q.-Z. Cohen, H. Bertolaccini, M.L. Erkan, D. Knight, J.S. Pons-Estel, G. Giannakopoulos, B. Krilis, S. de Jesus, G. Levy, R. Signorelli, F. Andrade, D. Balbi, G. Clarke, A.E. Skeith, L. Fortin, P.R. Ji, L. Zhang, Z. Yang, C. Shi, H. Zuily, S. Wahl, D. Tektonidou, M.G. Nalli, C. Andreoli, L. Tincani, A. Chighizola, C.B. Gerosa, M. Meroni, P. Pengo, V. Cheng, C. Pazzola, G. Sciascia, S. Foddai, S. Radin, M. Davis, S. Amengual, O. Atsumi, T. Uthman, I. Limper, M. de Groot, P. Ruiz-Irastorza, G. Ugarte, A. Rodriguez-Pinto, I. Cervera, R. Ríos-Garcés, R. Barilaro, G. Pardos-Gea, J. Almaraz, E.R. Cuadrado, M.J. Zamorano, M.A.A. Lopez-Pedrera, C. Artim-Esen, B. Inanc, M. Bertolaccini, M.L. Cohen, H. Efthymiou, M. Khamashta, M. Mackie, I. Sanna, G. Knight, J. Zuo, Y. Petri, M. Leaf, R.K. Roubey, R. Ortel, T. Gonzalez, E. Willis, R. Kello, N. Belmont, M. Levine, S. Rand, J. Barbhaiya, M. Erkan, D. Salmon, J. Lockshin, M. Duarte Garcia, A.A. Branch, D.W. the Antiphospholipid Syndrome Alliance for Clinical Trials InternatiOnal Networking and Zuo, Y. Navaz, S. Tsodikov, A. Kmetova, K. Kluge, L. Ambati, A. Hoy, C.K. Yalavarthi, S. de Andrade, D. Tektonidou, M.G. Sciascia, S. Pengo, V. Ruiz-Irastorza, G. Belmont, H.M. Gerosa, M. Fortin, P.R. de Jesus, G.R. Branch, D.W. Andreoli, L. Rodriguez-Almaraz, E. Petri, M. Cervera, R. Willis, R. Karp, D.R. Li, Q.-Z. Cohen, H. Bertolaccini, M.L. Erkan, D. Knight, J.S. Pons-Estel, G. Giannakopoulos, B. Krilis, S. de Jesus, G. Levy, R. Signorelli, F. Andrade, D. Balbi, G. Clarke, A.E. Skeith, L. Fortin, P.R. Ji, L. Zhang, Z. Yang, C. Shi, H. Zuily, S. Wahl, D. Tektonidou, M.G. Nalli, C. Andreoli, L. Tincani, A. Chighizola, C.B. Gerosa, M. Meroni, P. Pengo, V. Cheng, C. Pazzola, G. Sciascia, S. Foddai, S. Radin, M. Davis, S. Amengual, O. Atsumi, T. Uthman, I. Limper, M. de Groot, P. Ruiz-Irastorza, G. Ugarte, A. Rodriguez-Pinto, I. Cervera, R. Ríos-Garcés, R. Barilaro, G. Pardos-Gea, J. Almaraz, E.R. Cuadrado, M.J. Zamorano, M.A.A. Lopez-Pedrera, C. Artim-Esen, B. Inanc, M. Bertolaccini, M.L. Cohen, H. Efthymiou, M. Khamashta, M. Mackie, I. Sanna, G. Knight, J. Zuo, Y. Petri, M. Leaf, R.K. Roubey, R. Ortel, T. Gonzalez, E. Willis, R. Kello, N. Belmont, M. Levine, S. Rand, J. Barbhaiya, M. Erkan, D. Salmon, J. Lockshin, M. Duarte Garcia, A.A. Branch, D.W. the Antiphospholipid Syndrome Alliance for Clinical Trials InternatiOnal Networking

Abstract

Objective: This study aimed to elucidate the presence, antigen specificities, and potential clinical associations of anti–neutrophil extracellular trap (anti-NET) antibodies in a multinational cohort of antiphospholipid (aPL) antibody–positive patients who did not have lupus. Methods: Anti-NET IgG/IgM levels were measured in serum samples from 389 aPL-positive patients; 308 patients met the classification criteria for antiphospholipid syndrome. Multivariate logistic regression with best variable model selection was used to determine clinical associations. For a subset of the patients (n = 214), we profiled autoantibodies using an autoantigen microarray platform. Results: We found elevated levels of anti-NET IgG and/or IgM in 45% of the aPL-positive patients. High anti-NET antibody levels are associated with more circulating myeloperoxidase (MPO)–DNA complexes, which are a biomarker of NETs. When considering clinical manifestations, positive anti-NET IgG was associated with lesions affecting the white matter of the brain, even after adjusting for demographic variables and aPL profiles. Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; furthermore, patient serum samples containing high levels of anti-NET IgM efficiently deposited complement C3d on NETs. As determined by autoantigen microarray, positive testing for anti-NET IgG was significantly associated with several autoantibodies, including those recognizing citrullinated histones, heparan sulfate proteoglycan, laminin, MPO–DNA complexes, and nucleosomes. Anti-NET IgM positivity was associated with autoantibodies targeting single-stranded DNA, double-stranded DNA, and proliferating cell nuclear antigen. Conclusion: These data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade. While anti-NET IgM may especially recognize DNA in NETs, anti-NET IgG species appear to be more likely to target NET-associated

Published
2023

10. AB1635 RATES OF HIGH LEVELS OF POST-PARTUM DEPRESSIVE SYMPTOMATOLOGY IN WOMEN WITH RHEUMATIC DISEASES FOLLOWED DURING PREGNANCY, AND ASSOCIATIONS WITH TYPE OF DISEASE: A STUDY BY A MULTIDISCIPLINARY TEAM

Author

Crisafulli, F., primary, Pedretti, E., additional, Andreolassi, I., additional, Zatti, S., additional, Ramazzotto, F., additional, Beretta, E., additional, Bani, C., additional, Matthey, S., additional, Della Vedova, A. M., additional, Lini, D., additional, Nalli, C., additional, Gerardi, M. C., additional, Lazzaroni, M. G., additional, Semeraro, P., additional, Fredi, M., additional, Filippini, M., additional, Taglietti, M., additional, Franceschini, F., additional, Andreoli, L., additional, and Tincani, A., additional

Published
2023
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11. POS1299 LONG-TERM NEURODEVELOPMENTAL OUTCOME OF CHILDREN BORN TO SYSTEMIC SCLEROSIS WOMEN: PEDIATRIC NEUROPSYCHIATRIC ASSESSMENT THROUGH A SET OF VALIDATED TOOLS

Author

Pedretti, E., primary, Galli, J., additional, Moschetti, L., additional, Nalli, C., additional, Bendoni, M., additional, Visconti, L., additional, Molinaro, A., additional, Franceschini, F., additional, Tincani, A., additional, Airò, P., additional, Andreoli, L., additional, Fazzi, E., additional, and Lazzaroni, M. G., additional

Published
2023
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15. POS0741 REPORT FROM THE APS STUDY GROUP OF THE ITALIAN SOCIETY FOR RHEUMATOLOGY (SIR-APS) ON aPL NEGATIVIZATION

Author

Foddai, S. G., primary, Sciascia, S., additional, Alessandri, C., additional, Alunno, A., additional, Andreoli, L., additional, Barinotti, A., additional, Calligaro, A., additional, Canti, V., additional, Carubbi, F., additional, Cecchi, I., additional, Chighizola, C., additional, Conti, F., additional, Emmi, G., additional, Fioravanti, A., additional, Fischetti, F., additional, Franceschini, F., additional, Gerosa, M., additional, Hoxha, A., additional, Larosa, M., additional, Lazzaroni, M. G., additional, Nalli, C., additional, Pazzola, G., additional, Radin, M., additional, Raffeiner, B., additional, Ramoni, V., additional, Roccatello, D., additional, Rubini, E., additional, Sebastiani, G., additional, Truglia, S., additional, Urban, M. L., additional, and Tincani, A., additional

Published
2022
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16. AB0661 NEUROPSYCHOLOGICAL OUTCOME OF CHILDREN BORN TO WOMEN WITH SYSTEMIC SCLEROSIS ASSESSED THROUGH A SELF-ADMINISTERED MULTIDISCIPLINARY QUESTIONNAIRE: RESULTS FROM A MONOCENTRIC COHORT

Author

Moschetti, L., primary, Lazzaroni, M. G., additional, Pedretti, E., additional, Bano, A., additional, Nalli, C., additional, Cucchi, F., additional, Molinaro, A., additional, Galli, J., additional, Fazzi, E., additional, Franceschini, F., additional, Tincani, A., additional, Airò, P., additional, and Andreoli, L., additional

Published
2022
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18. POS0721 ASSOCIATION BETWEEN PRECONCEPTION COMPLEMENT LEVELS AND USE OF HYDROXYCHLOROQUINE WITH PREGNANCY OUTCOME IN PATIENTS WITH PRIMARY ANTIPHOSPHOLIPID SYNDROME AND CARRIERS OF ANTIPHOSPHOLIPID ANTIBODIES: AN INTERNATIONAL MULTICENTER STUDY

Author

Lini, D., primary, Nalli, C., additional, Andreoli, L., additional, Crisafulli, F., additional, Fredi, M., additional, Lazzaroni, M. G., additional, Bitsadze, V., additional, Calligaro, A., additional, Canti, V., additional, Caporali, R., additional, Carubbi, F., additional, Chighizola, C., additional, Conigliaro, P., additional, Conti, F., additional, De Carolis, C., additional, Del Ross, T., additional, Favaro, M., additional, Gerosa, M., additional, Iuliano, A., additional, Khizroeva, J., additional, Makatsariya, A., additional, Meroni, P. L., additional, Mosca, M., additional, Padovan, M., additional, Perricone, R., additional, Rovere-Querini, P., additional, Sebastiani, G. D., additional, Tani, C., additional, Tonello, M., additional, Truglia, S., additional, Zucchi, D., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2022
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19. OP0125 THE MANAGEMENT OF PREGNANCY IN AUTOIMMUNE RHEUMATIC DISEASES: ANALYSIS OF 758 PREGNANCIES FROM THE PROSPECTIVE NATIONWIDE P-RHEUM.IT STUDY (THE ITALIAN REGISTRY OF PREGNANCY IN THE RHEUMATIC DISEASES)

Author

Andreoli, L., primary, Gerardi, M. C., additional, Crisafulli, F., additional, Zanetti, A., additional, Rozza, D., additional, Gerosa, M., additional, Lini, D., additional, Filippini, M., additional, Fredi, M., additional, Nalli, C., additional, Lazzaroni, M. G., additional, Taglietti, M., additional, Franceschini, F., additional, Caporali, R., additional, Trespidi, L., additional, Erra, R., additional, Mosca, M., additional, Tani, C., additional, Zucchi, D., additional, Melissa, P., additional, Ruffilli, F., additional, Maranini, B., additional, Rovere-Querini, P., additional, Canti, V., additional, De Lorenzo, R., additional, Cutro, M. S., additional, Picerno, V., additional, Montecucco, C., additional, Ramoni, V., additional, Anelli, M. G., additional, Abbruzzese, A., additional, Serale, F., additional, Romeo, N., additional, Chimenti, M. S., additional, Cuomo, G., additional, Larosa, M., additional, Pata, A. P., additional, Iuliano, A., additional, Crepaldi, G., additional, Brucato, A., additional, Landolfi, G., additional, Carrara, G., additional, Bortoluzzi, A., additional, Scirè, C. A., additional, and Tincani, A., additional

Published
2022
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25. Clinical Delphi on aPLnegativization: report from the from the APS Study Group of the Italian Society for Rheumatology (SIR-APS)

Author

Sciascia, S, Foddai, Sg, Alessandri, C, Alunno, A, Andreli, L, Barinotti, A, Calligaro, A, Canti, V, Carubbi, F, Cecchi, I, Chighizola, Cb, Conti, F, Emmi, G, Fioravanti, A, Fischetti, F, Franceschini, F, Gerosa, M, Hoxha, A, Larosa, M, Lazzaroni, Mg, Nalli, C, Pazzola, G, Radin, M, Raffeiner, B, Ramoni, V, Rubini, E, Sebastiani, Gd, Truglia, S, Urban, Ml, Roccatello, D, and Tincani, A.

Published
2022

27. Erratum: Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): Report of 1640 cases from EUROAPS registry (Rheumatology (2020) 59 (1306-1314) DOI: 10.1093/rheumatology/kez419)

Author

Alijotas-Reig J., Esteve-Valverde E., Ferrer-Oliveras R., Saez-Comet L., Lefkou E., Mekinian A., Belizna C., Ruffatti A., Hoxha A., Tincani A., Nalli C., Marozio L., Maina A., Espinosa G., Rios-Garces R., Cervera R., Carolis S. D., Monteleone G., Latino O., Udry S., Llurba E., Garrido-Gimenez C., Trespidi L., Gerosa M., Chighizola C. B., Rovere-Querini P., Canti V., Mayer-Pickel K., Tabacco S., Arnau A., Trape J., Ruiz-Hidalgo D., Sos L., Farran-Codina I., Alijotas-Reig, J., Esteve-Valverde, E., Ferrer-Oliveras, R., Saez-Comet, L., Lefkou, E., Mekinian, A., Belizna, C., Ruffatti, A., Hoxha, A., Tincani, A., Nalli, C., Marozio, L., Maina, A., Espinosa, G., Rios-Garces, R., Cervera, R., Carolis, S. D., Monteleone, G., Latino, O., Udry, S., Llurba, E., Garrido-Gimenez, C., Trespidi, L., Gerosa, M., Chighizola, C. B., Rovere-Querini, P., Canti, V., Mayer-Pickel, K., Tabacco, S., Arnau, A., Trape, J., Ruiz-Hidalgo, D., Sos, L., and Farran-Codina, I.

Abstract

In the original article, the affiliation of co-author Cecilia Beatrice Chighizola should have read: “Experimental Laboratory of Immunological and Rheumatologic Researches, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan, Italy”. These details have been corrected only in this corrigendum to preserve the published version of record.

Published
2021

28. Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from the EUROAPS registry

Author

Alijotas-Reig, J., Esteve-Valverde, E., Ferrer-Oliveras, R., Saez-Comet, L., Lefkou, E., Mekinian, A., Belizna, C., Ruffatti, A., Hoxha, A., Tincani, A., Nalli, C., Marozio, L., Maina, A., Espinosa, G., Rios-Garces, R., Cervera, R., Carolis, S. D., Monteleone, G., Latino, O., Udry, S., Llurba, E., Garrido-Gimenez, C., Trespidi, L., Gerosa, M., Chighizola, C. B., Rovere-Querini, P., Canti, V., Mayer-Pickel, K., Tabacco, S., Arnau, A., Trape, J., Ruiz-Hidalgo, D., Sos, L., and Farran-Codina, I.

Subjects
Adult, medicine.medical_specialty, medicine.drug_class, antiphospholipid, antiphospholipid antibodies, antiphospholipid syndrome, non-criteria antiphospholipid syndrome, obstetric antiphospholipid syndrome, outcomes, treatment, Antibodies, Antiphospholipid, Antiphospholipid Syndrome, Aspirin, Female, Humans, Live Birth, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prospective Studies, Registries, Retrospective Studies, Treatment Outcome, Low molecular weight heparin, Antibodies, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Antiphospholipid syndrome, medicine, Pharmacology (medical), 030212 general & internal medicine, Prospective cohort study, 030203 arthritis & rheumatology, Obstetrics, business.industry, Retrospective cohort study, medicine.disease, Anti-thyroid autoantibodies, Clinical trial, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Live birth, business
Abstract

Objectives To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS). Methods This was a retrospective and prospective multicentre study from the European Registry on Obstetric Antiphospholipid Syndrome. Results A total of 1650 women with 5251 episodes, 3601 of which were historical and 1650 latest episodes, were included. Altogether, 1000 cases (OAPS group) fulfilled the Sydney classification criteria and 650 (NC-OAPS group) did not. Ten NC-OAPS cases were excluded for presenting thrombosis during follow-up. All cases were classified as category I (triple positivity or double positivity for aPL) or category II (simple positivity). Overall, aPL laboratory categories showed significant differences: 29.20% in OAPS vs 17.96% in NC-OAPS (P < 0.0001) for category I, and 70.8% in OAPS vs 82% in NC-OAPS (P < 0.0001) for category II. Significant differences were observed when current obstetric complications were compared (P < 0.001). However, major differences between groups were not observed in treatment rates, livebirths and thrombotic complications. In the NC-OAPS group, 176/640 (27.5%) did not fulfil Sydney clinical criteria (subgroup A), 175/640 (27.34%) had a low titre and/or non-persistent aPL positivity but did meet the clinical criteria (subgroup B) and 289/640 (45.15%) had a high aPL titre but did not fulfil Sydney clinical criteria (subgroup C). Conclusion Significant clinical and laboratory differences were found between groups. Fetal-maternal outcomes were similar in both groups when treated. These results suggest that we could improve our clinical practice with better understanding of NC-OAPS patients.

Published
2019
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29. Antiphospholipid antibody profile stability over time: Prospective results from the APS ACTION clinical database and repository

Author

Gkrouzman, E. Sevim, E. Finik, J. Andrade, D. Pengo, V. Sciascia, S. Tektonidou, M.G. Ugarte, A. Chighizola, C.B. Belmont, H.M. Lopez-Pedrera, C. Ji, L. Fortin, P. Efthymiou, M. de Jesus, G.R. Branch, D.W. Nalli, C. Petri, M. Rodriguez, E. Cervera, R. Knight, J.S. Atsumi, T. Willis, R. Bertolaccini, M.L. Cohen, H. Rand, J. Erkan, D.

Subjects
immune system diseases, neoplasms
Abstract

Objective. The 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 (1) whether baseline characteristics differ between patients with stable and unstable aPL profiles, and (2) predictors of unstable aPL profiles over time. Methods. A clinically meaningful aPL profile was defined as positive lupus anticoagulant (LAC) test and/or anticardiolipin (aCL)/anti-β2 glycoprotein-I (anti–β2-GPI) 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 yrs), 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 (OR 0.25, 95% CI 0.10–0.64, P = 0.004) and isolated LAC 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 profiles at baseline remain stable at a median follow-up of 5 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. © 2021 Journal of Rheumatology. All rights reserved.

Published
2021

30. Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from EUROAPS registry (vol 59, pg 1306, 2020)

Author

Alijotas-Reig, J, Esteve-Valverde, E, Ferrer-Oliveras, R, Saez-Comet, L, Lefkou, E, Mekinian, A, Belizna, C, Ruffatti, A, Hoxha, A, Tincani, A, Nalli, C, Marozio, L, Maina, A, Espinosa, G, Rios-Garces, R, Cervera, R, De Carolis, S, Monteleone, G, Latino, O, Udry, S, Llurba, E, Garrido-Gimenez, C, Trespidi, L, Gerosa, M, Chighizola, CB, Rovere-Querini, P, Canti, V, Mayer-Pickel, K, Tabacco, S, Arnau, A, Trape, J, Ruiz-Hidalgo, D, Sos, L, and Farran-Codina, I

Published
2021

31. Bleeding and antithrombotic therapy during pregnancy in women with poor aPL-related obstetric outcomes: A survey of 1075 cases from EUROAPS registry∗

Author

Alijotas-Reig, J., Esteve-Valverde, E., Ferrer-Oliveras, R., Saez-Comet, L., Lefkou, E., Mekinian, A., Belizna, C., Ruffatti, A., Tincani, A., Pardos-Gea, J., Nalli, C., Marozio, L., Espinosa, G., De Carolis, S., Latino, O., Sebastian, U., LLurba, E., Trespidi, L., Chighizola, C., Pengo, V., Rovere-Querini, P., Canti, V., Mayer-Pickel, K., Reshetnyak, T., Tabacco, S., Arnau, A., De Carolis S. (ORCID:0000-0002-5160-7609), Alijotas-Reig, J., Esteve-Valverde, E., Ferrer-Oliveras, R., Saez-Comet, L., Lefkou, E., Mekinian, A., Belizna, C., Ruffatti, A., Tincani, A., Pardos-Gea, J., Nalli, C., Marozio, L., Espinosa, G., De Carolis, S., Latino, O., Sebastian, U., LLurba, E., Trespidi, L., Chighizola, C., Pengo, V., Rovere-Querini, P., Canti, V., Mayer-Pickel, K., Reshetnyak, T., Tabacco, S., Arnau, A., and De Carolis S. (ORCID:0000-0002-5160-7609)

Abstract

BACKGROUND: The combination of low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH) until the end of gestation are the currently the accepted standard of care for the treatment of antiphospholipid-related obstetric disorders. In refractory cases, hydroxychloroquine (HCQ) can be added to this standard of care. OBJECTIVE: To evaluate the haemostatic safety of LDA and LMWH (medium to high prophylactic doses) during pregnancy and the puerperium in women with both full-blown obstetric antiphospholipid syndrome (OAPS) (Sydney criteria) and noncriteria - incomplete - OAPS. STUDY DESIGN: Retrospective/prospective multicentre observational study. Obstetric background, laboratory categories, delivery mode, antithrombotic regimens and bleeding complications were compared. SETTING: A total of 30 tertiary European hospitals. PATIENTS: Mainly, Caucasian/Arian pregnant women were included. Other ethnicities were minimally present. Women were controlled throughout pregnancy and puerperium. MAIN OUTCOME MEASURES: The primary end-point was to evaluate the number of major and minor haemorrhagic complications in this cohort of women. Neuraxial anaesthetic bleeding complications were particularly assessed. Secondly, we aimed to compare local/general bleeding events between groups. RESULTS: We studied 1650 women, of whom 1000 fulfilled the Sydney criteria of the OAPS and 650 did not (noncriteria OAPS). Data on antithrombotic-related complications were available in 1075 cases (65.15%). Overall, 53 (4.93%) women had bleeding complications, with 34 being considered minor (3.16%) and 19 major (1.76%). Neither obstetric complications nor laboratory categories were bleeding-related. Assisted vaginal delivery and caesarean section were related to local haemorrhage. Heparin doses and platelet count were not associated with major bleeding. CONCLUSIONS: LDA and medium to high prophylactic LMWH during pregnancy in women with full-blown OAPS/noncriteria OAPS are safe. A slight increase in

Published
2021

32. POS0476 CAN LOW-DOSE ASPIRIN DURING PREGNANCY PREVENT THE DEVELOPMENT OF ADVERSE PREGNANCY OUTCOMES IN WOMEN WITH ARTHRITIS? DATA FROM THE P-RHEUM.it STUDY

Author

Lini, D., primary, Gerardi, M. C., additional, Zanetti, A., additional, Carrara, G., additional, Bortoluzzi, A., additional, Crisafulli, F., additional, Filippini, M., additional, Fredi, M., additional, Gorla, R., additional, Lazzaroni, M. G., additional, Nalli, C., additional, Taglietti, M., additional, Lojacono, A., additional, Zatti, S., additional, Scirè, C. A., additional, Andreoli, L., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2021
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33. POS0593 THE REDUCTION OF RETINAL MICROVASCULAR ALTERATIONS AND THE DECREASE OF A POTENTIALLY RELATED T-CELL SUBSET IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS TREATED WITH ABATACEPT

Author

Piantoni, S., primary, Regola, F., additional, Masneri, S., additional, Nalli, C., additional, Bazzani, C., additional, Rossini, C., additional, Chiarini, G., additional, De Ciuceis, C., additional, Franceschini, F., additional, Rizzoni, D., additional, and Airò, P., additional

Published
2021
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34. POS0737 LOW PRECONCEPTIONAL COMPLEMENT LEVEL IS RELATED WITH ADVERSE OBSTETRIC OUTCOME IN A MULTICENTRIC COHORT OF PREGNANCY IN PATIENTS WITH APS AND APL POSITIVITY

Author

Lini, D., primary, Nalli, C., additional, Andreoli, L., additional, Crisafulli, F., additional, Fredi, M., additional, Lazzaroni, M. G., additional, Bitsadze, V., additional, Calligaro, A., additional, Canti, V., additional, Caporali, R., additional, Carubbi, F., additional, Chighizola, C., additional, Conigliaro, P., additional, Conti, F., additional, De Carolis, C., additional, Del Ross, T., additional, Favaro, M., additional, Gerosa, M., additional, Iuliano, A., additional, Khizroeva, J., additional, Makatsariya, A., additional, Meroni, P. L., additional, Mosca, M., additional, Melissa, P., additional, Perricone, R., additional, Rovere-Querini, P., additional, Sebastiani, G. D., additional, Tani, C., additional, Tonello, M., additional, Truglia, S., additional, Zucchi, D., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2021
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35. POS0760 MONITORING C3 AND C4 VARIATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS PREGNANCIES IS USEFUL TO RECOGNIZE COMPLICATIONS. DATA FROM 2 ITALIAN CENTERS

Author

Crisafulli, F., primary, Reggia, R., additional, Filippini, M., additional, Fredi, M., additional, Gerardi, M. C., additional, Gorla, R., additional, Lazzaroni, M. G., additional, Lini, D., additional, Nalli, C., additional, Taglietti, M., additional, Lojacono, A., additional, Zatti, S., additional, Zanardini, C., additional, Tani, C., additional, Zucchi, D., additional, Mosca, M., additional, Franceschini, F., additional, Andreoli, L., additional, and Tincani, A., additional

Published
2021
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36. AB0822 BREASTFEEDING AMONG WOMEN WITH RHEUMATIC DISEASES: ANALYSIS OF DATA FROM THE P-RHEUM.IT STUDY

Author

Panaro, S., primary, Gerardi, M. C., additional, Filippini, M., additional, Crisafulli, F., additional, Fredi, M., additional, Gorla, R., additional, Lazzaroni, M. G., additional, Lini, D., additional, Nalli, C., additional, Moschetti, L., additional, Regola, F., additional, Taglietti, M., additional, Bortoluzzi, A., additional, Zanetti, A., additional, Lojacono, A., additional, Zatti, S., additional, Scirè, C. A., additional, Carrara, G., additional, Ramazzotto, F., additional, Andreoli, L., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2021
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39. AB1635 RATES OF HIGH LEVELS OF POST-PARTUM DEPRESSIVE SYMPTOMATOLOGY IN WOMEN WITH RHEUMATIC DISEASES FOLLOWED DURING PREGNANCY, AND ASSOCIATIONS WITH TYPE OF DISEASE: A STUDY BY A MULTIDISCIPLINARY TEAM

Author

Crisafulli, F., Pedretti, E., Andreolassi, I., Zatti, S., Ramazzotto, F., Beretta, E., Bani, C., Matthey, S., Della Vedova, A.M., Lini, D., Nalli, C., Gerardi, M.C., Lazzaroni, M.G., Semeraro, P., Fredi, M., Filippini, M., Taglietti, M., Franceschini, F., Andreoli, L., and Tincani, A.

Published
2023
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41. SAT0368 PREGNANCY IN WOMEN WITH SPONDYLOARTHRITIS: WHO ARE THE PATIENTS AT RISK OF DISEASE FLARE?

Author

Crisafulli, F., primary, Cruz-Machado, A. R., additional, Gerardi, M. C., additional, Filippini, M., additional, Fredi, M., additional, Gorla, R., additional, Lazzaroni, M. G., additional, Nalli, C., additional, Taglietti, M., additional, Lojacono, A., additional, Zanardini, C., additional, Zatti, S., additional, Andreoli, L., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2020
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42. AB0678 RISK FACTORS FOR ADVERSE PREGNANCY OUTCOMES IN SPONDYLOARTHRITIS: DISEASE PHENOTYPE AND DISEASE ACTIVITY MAY PLAY A ROLE

Author

Cruz-Machado, A. R., primary, Crisafulli, F., additional, Gerardi, M. C., additional, Filippini, M., additional, Fredi, M., additional, Gorla, R., additional, Lazzaroni, M. G., additional, Nalli, C., additional, Taglietti, M., additional, Lojacono, A., additional, Zinardini, C., additional, Zatti, S., additional, Andreoli, L., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2020
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45. SAT0202 C4 LEVELS AS PREDICTOR OF DISEASE FLARES AND ADVERSE PREGNANCY OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOSUS PREGNANCIES

Author

Crisafulli, F., primary, Gerardi, M. C., additional, Filippini, M., additional, Gorla, R., additional, Fredi, M., additional, Lazzaroni, M. G., additional, Taglietti, M., additional, Nalli, C., additional, Zatti, S., additional, Zanardini, C., additional, Lojacono, A., additional, Andreoli, L., additional, Franceschini, F., additional, and Tincani, A., additional

Published
2020
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46. Coronary Artery Disease of the Donor Graft: Any Impact on Survival and Cardiac Allograft Vasculopathy after Heart Transplantation?

Author

Lechiancole, A., primary, Sponga, S., additional, Vendramin, I., additional, Ferrara, V., additional, Maiani, M., additional, Spagna, E., additional, Guzzi, G., additional, Nalli, C., additional, Meneguzzi, M., additional, Nora, C. Di, additional, Piani, D., additional, Benedetti, G., additional, Tursi, V., additional, Zanuttini, D., additional, and Livi, U., additional

Published
2020
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47. Antiphospholipid syndrome: State of the art on clinical practice guidelines

Author

Limper, M, Scire, C, Talarico, R, Amoura, Z, Avcin, T, Basile, M, Burmester, G, Carli, L, Cervera, R, Costedoat-Chalumeau, N, Doria, A, Dorner, T, Fonseca, J, Galetti, I, Hachulla, E, Launay, D, Lourenco, F, Macieira, C, Meroni, P, Montecucco, C, Moraes-Fontes, M, Mouthon, L, Nalli, C, Ramoni, V, Tektonidou, M, Van Laar, J, Bombardieri, S, Schneider, M, Smith, V, Vieira, A, Cutolo, M, Mosca, M, Tincani, A, Limper M., Scire C. A., Talarico R., Amoura Z., Avcin T., Basile M., Burmester G., Carli L., Cervera R., Costedoat-Chalumeau N., Doria A., Dorner T., Fonseca J. E., Galetti I., Hachulla E., Launay D., Lourenco F., Macieira C., Meroni P., Montecucco C. M., Moraes-Fontes M. F., Mouthon L., Nalli C., Ramoni V., Tektonidou M., Van Laar J. M., Bombardieri S., Schneider M., Smith V., Vieira A., Cutolo M., Mosca M., Tincani A., Limper, M, Scire, C, Talarico, R, Amoura, Z, Avcin, T, Basile, M, Burmester, G, Carli, L, Cervera, R, Costedoat-Chalumeau, N, Doria, A, Dorner, T, Fonseca, J, Galetti, I, Hachulla, E, Launay, D, Lourenco, F, Macieira, C, Meroni, P, Montecucco, C, Moraes-Fontes, M, Mouthon, L, Nalli, C, Ramoni, V, Tektonidou, M, Van Laar, J, Bombardieri, S, Schneider, M, Smith, V, Vieira, A, Cutolo, M, Mosca, M, Tincani, A, Limper M., Scire C. A., Talarico R., Amoura Z., Avcin T., Basile M., Burmester G., Carli L., Cervera R., Costedoat-Chalumeau N., Doria A., Dorner T., Fonseca J. E., Galetti I., Hachulla E., Launay D., Lourenco F., Macieira C., Meroni P., Montecucco C. M., Moraes-Fontes M. F., Mouthon L., Nalli C., Ramoni V., Tektonidou M., Van Laar J. M., Bombardieri S., Schneider M., Smith V., Vieira A., Cutolo M., Mosca M., and Tincani A.

Abstract

Antiphospholipid syndrome (APS) is a rare disease characterised by venous and/or arterial thrombosis, pregnancy complications and the presence of specific autoantibodies called antiphospholipid antibodies. This review aims to identify existing clinical practice guidelines (CPG) as part of the ERN ReCONNET project, aimed at evaluating existing CPGs or recommendations in rare and complex diseases. Seventeen papers providing important data were identified; however, the literature search highlighted the scarceness of reliable clinical data to develop CPGs. With no formal clinical guidelines in place, diagnosis and treatment of APS is largely based on consensus and expert opinion. Patients' unmet need refers to the understanding of the disease and its clinical picture and implications, the need of education for patients, family members and healthcare providers, as well as to the development of monitoring pathways involving multiple healthcare providers.

Published
2018

48. Recurrent thrombosis in patients with antiphospholipid antibodies and arterial thrombosis on antithrombotic therapy

Author

Giannakopoulos, B, Krilis, S, de Jesus, G, Levy, R, Rosa, R, Andrade, D, Fortin, Pf, Zhang, Z, Zuily, S, Wahl, D, Tektonidou, M, Nalli, C, Andreoli, L, Tincani, A, Chighizola, Cb, Gerosa, M, Meroni, P, Banzato, A, Pengo, V, Sciascia, S, De Ceulaer, K, Davis, S, Atsumi, T, Uthman, I, Derksen, R, Degroot, P, Ugarte, A, Ruiz Irastorza, G, Rodriguez-Pinto, I, Pons-Estel, G, Cervera, R, Rodriguez, E, Aguirre Zamorano MA, Lopez-Pedrera), R, Mackie, I, Efthymiou, M, Cohen, H, Bertolaccini, Ml, Cuadrado, M, Khamashta, M, Sanna, G, Petri, M, Roubey, R, Knight, Js, Ortel, T, Gonzalez, E, Willis, Jhon Raymond, Levine, S, Rand, J, Belmont, Hm, Barbhaiya, M, Erkan, D, Salmon, J, Lockshin, M, Branch, W, Jackson, Wg, Oromendia, C, Unlu, O, and Desancho, Mt

Subjects
030203 arthritis & rheumatology, medicine.medical_specialty, biology, medicine.drug_class, business.industry, Anticoagulant, Hematology, 030204 cardiovascular system & hematology, Single Center, medicine.disease, Thrombosis, Thrombosis and Hemostasis, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, Antiphospholipid syndrome, Internal medicine, Antithrombotic, medicine, biology.protein, In patient, Antibody, business
Abstract

Management for patients with antiphospholipid syndrome (APS) and arterial thrombosis is controversial. There are no prospective data demonstrating the superiority of high- or moderate-intensity anticoagulation with vitamin K antagonists over antiplatelet agents. Using 2 antiphospholipid antibody databases (single center [New York Presbyterian Hospital] and multicenter [Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking]), we retrospectively collected demographic and clinical data of patients with APS and arterial thrombosis. The primary outcome was recurrent thrombosis rate after initial arterial thrombosis in patients with APS treated with antiplatelet and/or anticoagulant therapy. We identified 139 patients with a median follow-up time of 4.24 years after initial thrombosis. Thirty-seven patients (27.3%) received anticoagulants, 43 (30.9%) antiplatelets, and 58 (41.7%) combined therapy. Sixteen patients (37.2%) in the antiplatelet group, 9 (23.7%) in the anticoagulant group, and 4 (6.9%) in the combined therapy group experienced recurrent thrombosis. We estimate that 20% of patients will experience a recurrence by 3.4, 7.3, and 16.3 years, respectively, depending on assignment to antiplatelet, anticoagulant, or combined therapy. These results suggest that combined therapy decreases the rate of and increases the time to thrombosis recurrence in patients with APS presenting with arterial thrombosis.

Published
2017
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49. Comparative study of obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric APS (NC-OAPS): report of 1640 cases from the EUROAPS registry

Author

Alijotas-Reig, J, Esteve-Valverde, E, Ferrer-Oliveras, R, Saez-Comet, L, Lefkou, E, Mekinian, A, Belizna, C, Ruffatti, A, Hoxha, A, Tincani, A, Nalli, C, Marozio, L, Maina, A, Espinosa, G, Rios-Garces, R, Cervera, R, De Carolis, S, Monteleone, G, Latino, O, Udry, S, Llurba, E, Garrido-Gimenez, C, Trespidi, L, Gerosa, M, Chighizola, CB, Rovere-Querini, P, Canti, V, Mayer-Pickel, K, Tabacco, S, Arnau, A, Trape, J, Ruiz-Hidalgo, D, Sos, L, Farran-Codina, I, and EUROAPS Study Grp

Subjects
antiphospholipid, treatment, antiphospholipid antibodies, non-criteria antiphospholipid syndrome, obstetric antiphospholipid syndrome, outcomes, antiphospholipid syndrome
Abstract

Objectives. To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS). Methods. This was a retrospective and prospective multicentre study from the European Registry on Obstetric Antiphospholipid Syndrome. Results. A total of 1650 women with 5251 episodes, 3601 of which were historical and 1650 latest episodes, were included. Altogether, 1000 cases (OAPS group) fulfilled the Sydney classification criteria and 650 (NC-OAPS group) did not. Ten NC-OAPS cases were excluded for presenting thrombosis during follow-up. All cases were classified as category I (triple positivity or double positivity for aPL) or category II (simple positivity). Overall, aPL laboratory categories showed significant differences: 29.20% in OAPS vs 17.96% in NC-OAPS (P < 0.0001) for category I, and 70.8% in OAPS vs 82% in NC-OAPS (P < 0.0001) for category II. Significant differences were observed when current obstetric complications were compared (P < 0.001). However, major differences between groups were not observed in treatment rates, livebirths and thrombotic complications. In the NC-OAPS group, 176/640 (27.5%) did not fulfil Sydney clinical criteria (subgroup A), 175/640 (27.34%) had a low titre and/or non-persistent aPL positivity but did meet the clinical criteria (subgroup B) and 289/640 (45.15%) had a high aPL titre but did not fulfil Sydney clinical criteria (subgroup C). Conclusion. Significant clinical and laboratory differences were found between groups. Fetal-maternal outcomes were similar in both groups when treated. These results suggest that we could improve our clinical practice with better understanding of NC-OAPS patients.

Published
2020

50. Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry

Author

Zuily, S. Clerc-Urmès, I. Bauman, C. Andrade, D. Sciascia, S. Pengo, V. Tektonidou, M.G. Ugarte, A. Gerosa, M. Michael Belmont, H. Zamorano, M.A.A. Fortin, P. Ji, L. Efthymiou, M. Cohen, H. Branch, D.W. Jesus, G.R.D. Nalli, C. Petri, M. Rodriguez, E. Cervera, R. Knight, J.S. Atsumi, T. Willis, R. Bertolaccini, M.L. Vega, J. Wahl, D. Erkan, D. APS ACTION Investigators

Subjects
immune system diseases, neoplasms
Abstract

Objective: This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients. Methods: The Alliance for Clinical Trials and International Networking (APS ACTION) Registry includes persistently positive aPL of any isotype based on the Sydney antiphospholipid syndrome (APS) classification criteria. We performed CA on the baseline characteristics collected retrospectively at the time of the registry entry of the first 500 patients included in the registry. A total of 30 clinical data points were included in the primary CA to cover the broad spectrum of aPL-positive patients. Results: A total of 497 patients from international centres were analysed, resulting in three main exclusive clusters: (a) female patients with no other autoimmune diseases but with venous thromboembolism (VTE) and triple-aPL positivity; (b) female patients with systemic lupus erythematosus, VTE, aPL nephropathy, thrombocytopaenia, haemolytic anaemia and a positive lupus anticoagulant test; and (c) older men with arterial thrombosis, heart valve disease, livedo, skin ulcers, neurological manifestations and cardiovascular disease (CVD) risk factors. Conclusions: Based on our hierarchical cluster analysis, we identified different clinical phenotypes of aPL-positive patients discriminated by aPL profile, lupus or CVD risk factors. Our results, while supporting the heterogeneity of aPL-positive patients, also provide a foundation to understand disease mechanisms, create new approaches for APS classification and ultimately develop new management approaches. © The Author(s) 2020.

Published
2020

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