RT Journal Article
T1 Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry.
A1 Zuily, Stéphane
A1 Clerc-Urmès, Isabelle
A1 Bauman, Cédric
A1 Andrade, Danieli
A1 Sciascia, Savino
A1 Pengo, Vittorio
A1 Tektonidou, Maria G
A1 Ugarte, Amaia
A1 Gerosa, Maria
A1 Michael Belmont, H
A1 Zamorano, Maria Angeles Aguirre
A1 Fortin, Paul
A1 Ji, Lanlan
A1 Efthymiou, Maria
A1 Cohen, Hannah
A1 Branch, D Ware
A1 Jesus, Guilherme Ramires de
A1 Nalli, Cecilia
A1 Petri, Michelle
A1 Rodriguez, Esther
A1 Cervera, Ricard
A1 Knight, Jason S
A1 Atsumi, Tatsuya
A1 Willis, Rohan
A1 Bertolaccini, Maria Laura
A1 Vega, Joann
A1 Wahl, Denis
A1 Erkan, Doruk
A1 APS ACTION Investigators, 
K1 APS ACTION
K1 Antiphospholipid syndrome
K1 cardiovascular risk factors
K1 systemic lupus erythematosus
K1 triple positivity
AB This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients. 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. 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. 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.
YR 2020
FD 2020-07-23
LK https://hdl.handle.net/10668/28219
UL https://hdl.handle.net/10668/28219
LA en
DS RISalud
RD Apr 6, 2025