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Antiphospholipid syndrome: five year follow up.
R A Asherson1, E Baguley, C Pal
1Lupus Arthritis Research Unit, Rayne Institute, St Thomas's Hospital, London.
Annals of the Rheumatic Diseases
|November 1, 1991
Summary
Patients with antiphospholipid antibodies and a history of clotting events were studied. Higher lupus activity correlated with recurrent thromboses, and treatments like steroids and immunosuppression did not prevent further vascular occlusions.
Area of Science:
- Rheumatology
- Hematology
- Immunology
Background:
- Antiphospholipid antibodies (aPL) are associated with an increased risk of thromboembolic events.
- Understanding the long-term outcomes and risk factors for recurrent events in patients with aPL is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between anticardiolipin antibody levels/isotypes and recurrent thromboembolic events in patients with a history of occlusions.
- To evaluate the efficacy of various treatments, including corticosteroids, immunosuppression, and anticoagulation, in preventing further vascular occlusions.
Main Methods:
- A longitudinal study of 19 patients with antiphospholipid antibodies and a history of venous/arterial occlusions.
- Patients were divided into two groups: those with no further events and those with recurrent thrombotic events over a five-year period.
- Data collected included antibody levels, isotype, lupus activity, and treatment regimens.
Main Results:
- Recurrent thromboembolic events were associated with higher lupus activity.
- Antiphospholipid antibodies remained positive and levels were generally stable.
- Corticosteroids and immunosuppression did not prevent recurrent occlusions; anticoagulation and aspirin showed variable efficacy, with complications noted in some patients.
Conclusions:
- Lupus activity is a significant factor in recurrent thromboembolic events in patients with antiphospholipid antibodies.
- Standard treatments may not fully protect against vascular occlusions, highlighting the need for further research into optimal management strategies.