Clinical relevance of antiphospholipid antibodies in systemic sclerosis

A systematic review and meta-analysis

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the clinical relevance of antiphospholipid antibodies (aPL) in systemic sclerosis (SSc).

METHODS: A systematic search of EMBASE and PubMed databases from January 1983 to July 2016 was carried out according to PRISMA guidelines whereas Peto׳s odds ratio (OR) for rare events was used for the meta-analysis.

RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) antibodies was higher in SSc than controls (12.8% vs 1.6% and 7.8% vs 0.6%; p < 0.0001 for both) as was that of IgG and IgM anti-beta-2-glycoprotein-I antibodies (aβ2GPI) (6.1% vs 0.58%, p < 0.0001; 3.5% vs 0.3%, p = 0.001). The pooled prevalence of pulmonary arterial hypertension (PAH) was more common in SSc positive than negative patients for aCL (IgG/IgM combined) (26.5% vs 10.9%, p < 0.0001) whereas the pooled prevalence of renal disease (RD) was more common in IgG aCL positive than negative patients (36.3% vs 10.9%, p = 0.02). The pooled prevalence of thrombosis was higher in IgG aCL, IgM aCL, and IgM aβ2GPI positive than negative SSc patients (12.6% vs 1.4%, p < 0.0001), (15.1% vs 2.7%, p = 0.002) and (15% vs 0.78%, p = 0.009), respectively. The pooled prevalence of digital infarction/ischemia (DI) was higher in IgG aCL and IgM positive than negative SSc (52.8% vs 39.8%, p = 0.002) and (68.1% vs 29%, p = 0.07).

CONCLUSIONS: A strong relationship exists between aCL and aβ2GPI of IgG/IgM isotype and SSc; patients positive for these antibodies are more likely to suffer from PAH, RD, thrombosis, and DI. However, data expressed as frequency of aPL positive patients rather than average antibody titers preclude further insight into the relevance of these assumptions.

Original languageEnglish
Pages (from-to)615-624
Number of pages10
JournalSeminars in Arthritis and Rheumatism
Volume46
Issue number5
Early online date13 Oct 2016
DOIs
Publication statusPublished - Apr 2017

Fingerprint

Antiphospholipid Antibodies
Systemic Scleroderma
Meta-Analysis
Immunoglobulin G
beta 2-Glycoprotein I
Immunoglobulin M
Antibodies
Pulmonary Hypertension
Infarction
Thrombosis
Ischemia
Kidney
Anticardiolipin Antibodies
PubMed
Odds Ratio
Databases
Guidelines

Keywords

  • Anti-beta(2)glycoprotein-I
  • Anticardiolipin
  • Antiphospholipid antibodies
  • Lupus anticoagulant
  • Systemic sclerosis

Cite this

@article{b66d9450a7444271b800ebcb61bca205,
title = "Clinical relevance of antiphospholipid antibodies in systemic sclerosis: A systematic review and meta-analysis",
abstract = "OBJECTIVE: To evaluate the clinical relevance of antiphospholipid antibodies (aPL) in systemic sclerosis (SSc).METHODS: A systematic search of EMBASE and PubMed databases from January 1983 to July 2016 was carried out according to PRISMA guidelines whereas Peto׳s odds ratio (OR) for rare events was used for the meta-analysis.RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) antibodies was higher in SSc than controls (12.8{\%} vs 1.6{\%} and 7.8{\%} vs 0.6{\%}; p < 0.0001 for both) as was that of IgG and IgM anti-beta-2-glycoprotein-I antibodies (aβ2GPI) (6.1{\%} vs 0.58{\%}, p < 0.0001; 3.5{\%} vs 0.3{\%}, p = 0.001). The pooled prevalence of pulmonary arterial hypertension (PAH) was more common in SSc positive than negative patients for aCL (IgG/IgM combined) (26.5{\%} vs 10.9{\%}, p < 0.0001) whereas the pooled prevalence of renal disease (RD) was more common in IgG aCL positive than negative patients (36.3{\%} vs 10.9{\%}, p = 0.02). The pooled prevalence of thrombosis was higher in IgG aCL, IgM aCL, and IgM aβ2GPI positive than negative SSc patients (12.6{\%} vs 1.4{\%}, p < 0.0001), (15.1{\%} vs 2.7{\%}, p = 0.002) and (15{\%} vs 0.78{\%}, p = 0.009), respectively. The pooled prevalence of digital infarction/ischemia (DI) was higher in IgG aCL and IgM positive than negative SSc (52.8{\%} vs 39.8{\%}, p = 0.002) and (68.1{\%} vs 29{\%}, p = 0.07).CONCLUSIONS: A strong relationship exists between aCL and aβ2GPI of IgG/IgM isotype and SSc; patients positive for these antibodies are more likely to suffer from PAH, RD, thrombosis, and DI. However, data expressed as frequency of aPL positive patients rather than average antibody titers preclude further insight into the relevance of these assumptions.",
keywords = "Anti-beta(2)glycoprotein-I, Anticardiolipin, Antiphospholipid antibodies, Lupus anticoagulant, Systemic sclerosis",
author = "Mira Merashli and Alves, {Jos{\'e} Delgado} and Ames, {Paul R J}",
note = "Copyright {\circledC} 2016 Elsevier Inc. All rights reserved.",
year = "2017",
month = "4",
doi = "10.1016/j.semarthrit.2016.10.004",
language = "English",
volume = "46",
pages = "615--624",
journal = "Seminars in Arthritis and Rheumatism",
issn = "0049-0172",
publisher = "W B SAUNDERS CO-ELSEVIER INC",
number = "5",

}

TY - JOUR

T1 - Clinical relevance of antiphospholipid antibodies in systemic sclerosis

T2 - A systematic review and meta-analysis

AU - Merashli, Mira

AU - Alves, José Delgado

AU - Ames, Paul R J

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2017/4

Y1 - 2017/4

N2 - OBJECTIVE: To evaluate the clinical relevance of antiphospholipid antibodies (aPL) in systemic sclerosis (SSc).METHODS: A systematic search of EMBASE and PubMed databases from January 1983 to July 2016 was carried out according to PRISMA guidelines whereas Peto׳s odds ratio (OR) for rare events was used for the meta-analysis.RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) antibodies was higher in SSc than controls (12.8% vs 1.6% and 7.8% vs 0.6%; p < 0.0001 for both) as was that of IgG and IgM anti-beta-2-glycoprotein-I antibodies (aβ2GPI) (6.1% vs 0.58%, p < 0.0001; 3.5% vs 0.3%, p = 0.001). The pooled prevalence of pulmonary arterial hypertension (PAH) was more common in SSc positive than negative patients for aCL (IgG/IgM combined) (26.5% vs 10.9%, p < 0.0001) whereas the pooled prevalence of renal disease (RD) was more common in IgG aCL positive than negative patients (36.3% vs 10.9%, p = 0.02). The pooled prevalence of thrombosis was higher in IgG aCL, IgM aCL, and IgM aβ2GPI positive than negative SSc patients (12.6% vs 1.4%, p < 0.0001), (15.1% vs 2.7%, p = 0.002) and (15% vs 0.78%, p = 0.009), respectively. The pooled prevalence of digital infarction/ischemia (DI) was higher in IgG aCL and IgM positive than negative SSc (52.8% vs 39.8%, p = 0.002) and (68.1% vs 29%, p = 0.07).CONCLUSIONS: A strong relationship exists between aCL and aβ2GPI of IgG/IgM isotype and SSc; patients positive for these antibodies are more likely to suffer from PAH, RD, thrombosis, and DI. However, data expressed as frequency of aPL positive patients rather than average antibody titers preclude further insight into the relevance of these assumptions.

AB - OBJECTIVE: To evaluate the clinical relevance of antiphospholipid antibodies (aPL) in systemic sclerosis (SSc).METHODS: A systematic search of EMBASE and PubMed databases from January 1983 to July 2016 was carried out according to PRISMA guidelines whereas Peto׳s odds ratio (OR) for rare events was used for the meta-analysis.RESULTS: The pooled prevalence of participants positive for IgG and IgM anticardiolipin (aCL) antibodies was higher in SSc than controls (12.8% vs 1.6% and 7.8% vs 0.6%; p < 0.0001 for both) as was that of IgG and IgM anti-beta-2-glycoprotein-I antibodies (aβ2GPI) (6.1% vs 0.58%, p < 0.0001; 3.5% vs 0.3%, p = 0.001). The pooled prevalence of pulmonary arterial hypertension (PAH) was more common in SSc positive than negative patients for aCL (IgG/IgM combined) (26.5% vs 10.9%, p < 0.0001) whereas the pooled prevalence of renal disease (RD) was more common in IgG aCL positive than negative patients (36.3% vs 10.9%, p = 0.02). The pooled prevalence of thrombosis was higher in IgG aCL, IgM aCL, and IgM aβ2GPI positive than negative SSc patients (12.6% vs 1.4%, p < 0.0001), (15.1% vs 2.7%, p = 0.002) and (15% vs 0.78%, p = 0.009), respectively. The pooled prevalence of digital infarction/ischemia (DI) was higher in IgG aCL and IgM positive than negative SSc (52.8% vs 39.8%, p = 0.002) and (68.1% vs 29%, p = 0.07).CONCLUSIONS: A strong relationship exists between aCL and aβ2GPI of IgG/IgM isotype and SSc; patients positive for these antibodies are more likely to suffer from PAH, RD, thrombosis, and DI. However, data expressed as frequency of aPL positive patients rather than average antibody titers preclude further insight into the relevance of these assumptions.

KW - Anti-beta(2)glycoprotein-I

KW - Anticardiolipin

KW - Antiphospholipid antibodies

KW - Lupus anticoagulant

KW - Systemic sclerosis

U2 - 10.1016/j.semarthrit.2016.10.004

DO - 10.1016/j.semarthrit.2016.10.004

M3 - Review article

VL - 46

SP - 615

EP - 624

JO - Seminars in Arthritis and Rheumatism

JF - Seminars in Arthritis and Rheumatism

SN - 0049-0172

IS - 5

ER -