Clinical Delphi on aPL Negativization: Report from the APS Study Group of the Italian Society for Rheumatology (SIR-APS).

Antibodies, Antiphospholipid Anticoagulants Antiphospholipid Syndrome Fibrinolytic Agents Humans Rheumatology Thrombosis

Journal

Thrombosis and haemostasis
ISSN: 2567-689X
Titre abrégé: Thromb Haemost
Pays: Germany
ID NLM: 7608063

Informations de publication

Date de publication:
Sep 2022
Historique:
pubmed: 17 3 2022
medline: 31 8 2022
entrez: 16 3 2022
Statut: ppublish

Résumé

 The rate of antiphospholipid antibody (aPL) negativization in antiphospholipid syndrome (APS) patients is uncertain, but it is estimated to be as high as 8%. Currently, a consensus definition of aPL negativization is lacking, as well as international recommendations on how to approach treatment in patients with a persistent aPL-negative seroconversion.  The aim of the Delphi survey was to evaluate the clinical approach and level of consensus among experts from the APS Study Group of the Italian Society for Rheumatology (SIR-APS) in different clinical scenarios.  Experts of SIR-APS were contacted using a survey methodology.  A structured survey was circulated among 30 experts. Up to 90% of the interviewed experts agreed on defining aPL negativization as the presence of two negative determinations, 1 year apart (90%). Almost full consensus exists among experts in some clinical settings, including: (1) the role of aPL negativization in the management of a thrombotic event determined by concomitant presence of cardiovascular risk factors, both modifiable and not modifiable (90%); (2) approach to young patients with triple aPL positivity who experienced pulmonary arterial thrombotic events and tested negative for aPL detection after 5 years of vitamin K antagonist (VKA) treatment (90%); (3) the use of "  A substantial agreement exists among experts on how to define aPL negativization. VKA suspension should be embraced with extreme caution, particularly in case of previous thrombotic events and/or triple aPL positivity. Nevertheless, VKA cessation might be considered when risk factors are carefully monitored/treated and the presence of "

Sections du résumé

BACKGROUND BACKGROUND
 The rate of antiphospholipid antibody (aPL) negativization in antiphospholipid syndrome (APS) patients is uncertain, but it is estimated to be as high as 8%. Currently, a consensus definition of aPL negativization is lacking, as well as international recommendations on how to approach treatment in patients with a persistent aPL-negative seroconversion.
AIM OBJECTIVE
 The aim of the Delphi survey was to evaluate the clinical approach and level of consensus among experts from the APS Study Group of the Italian Society for Rheumatology (SIR-APS) in different clinical scenarios.
METHODS METHODS
 Experts of SIR-APS were contacted using a survey methodology.
RESULTS RESULTS
 A structured survey was circulated among 30 experts. Up to 90% of the interviewed experts agreed on defining aPL negativization as the presence of two negative determinations, 1 year apart (90%). Almost full consensus exists among experts in some clinical settings, including: (1) the role of aPL negativization in the management of a thrombotic event determined by concomitant presence of cardiovascular risk factors, both modifiable and not modifiable (90%); (2) approach to young patients with triple aPL positivity who experienced pulmonary arterial thrombotic events and tested negative for aPL detection after 5 years of vitamin K antagonist (VKA) treatment (90%); (3) the use of "
CONCLUSION CONCLUSIONS
 A substantial agreement exists among experts on how to define aPL negativization. VKA suspension should be embraced with extreme caution, particularly in case of previous thrombotic events and/or triple aPL positivity. Nevertheless, VKA cessation might be considered when risk factors are carefully monitored/treated and the presence of "

Identifiants

DOI: 10.1055/a-1798-2400 PMID: 35292950
pubmed: 35292950
doi: 10.1055/a-1798-2400
doi:

Substances chimiques

Antibodies, Antiphospholipid 0
Anticoagulants 0
Fibrinolytic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1612-1620

Commentaires et corrections

Type : ErratumIn

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Savino Sciascia (S)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
ORCID: 0000-0003-1266-9441

Silvia Grazietta Foddai (SG)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Cristiano Alessandri (C)

Reumatologia, Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.

Alessia Alunno (A)

Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy.

Laura Andreoli (L)

Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Alice Barinotti (A)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Antonia Calligaro (A)

Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.

Valentina Canti (V)

Internal Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Francesco Carubbi (F)

Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy.

Irene Cecchi (I)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Cecillia B Chighizola (CB)

Division of Rheumatology, Department of Clinical Sciences and Community Health, Ospedale Gaetano Pini, University of Milan, Milan, Italy.

Fabrizio Conti (F)

Reumatologia, Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.

Giacomo Emmi (G)

Internal Interdisciplinary Medicine Unit, Lupus Clinic, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy.

Antonella Fioravanti (A)

Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Siena, Italy.

Fabio Fischetti (F)

Rheumatology Unit, SUGI and Clinical University Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

Franco Franceschini (F)

Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Maria Gerosa (M)

Division of Rheumatology, Department of Clinical Sciences and Community Health, Ospedale Gaetano Pini, University of Milan, Milan, Italy.

Ariela Hoxha (A)

Internal Medicine, University of Padua, Padua, Italy.

Maddalena Larosa (M)

Rheumatology, Department of Locomotor System, ASL3, Genova, Italy.

Maria-Grazia Lazzaroni (MG)

Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Cecilia Nalli (C)

Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Giulia Pazzola (G)

Rheumatology Unit, Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Università di Modenae Reggio Emilia, Reggio Emilia, Italy.

Massimo Radin (M)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Bernd Raffeiner (B)

Rheumatology Unit, Department of Medicine, Azienda Sanitaria dell'Alto Adige, Bolzano, Italy.

Veronique L Ramoni (VL)

Internal Medicine, Ospedale di Lodi, Italy.

Elena Rubini (E)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Gian Domenico Sebastiani (GD)

U.O.C. Reumatologia, Ospedale San Camillo-Forlanini, Roma, Italy.

Simona Truglia (S)

Reumatologia, Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.

Maria Letizia Urban (ML)

Internal Interdisciplinary Medicine Unit, Lupus Clinic, Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy.

Dario Roccatello (D)

SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital, Center of Research of Immunopathology and Rare Diseases-Coordinating Center of Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

Angela Tincani (A)

Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

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Classifications MeSH

questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Autoanticorps › Anticorps antiphospholipides › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Anticoagulants › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Syndrome des anticorps antiphospholipides › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Fibrinolytiques › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Professions de santé › Médecine › Médecine interne › Rhumatologie › Clinical Delphi on aPL Negativization: Report...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thrombose › Clinical Delphi on aPL Negativization: Report...