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4. French protocol for the diagnosis and management of systemic lupus erythematosus

Author

Andre, Marc, Bienvenu, Boris, Blaison, Gilles, Blanco, Patrick, Cathebras, Pascal, Chauveau, Dominique, Chosidow, Olivier, Clouscard, Johanna, Deligny, Christophe, Duhaut, Pierre, Gobert, Pierre, Levesque, Hervé, Magy-Bertrand, Nadine, Melki, Isabelle, Pha, Micheline, Puechal, Xavier, Queyrel, Viviane, Raffray, Loïc, Ranchin, Bruno, Riviere, Marianne, Roblot, Pascal, Servettaz, Amelie, Amoura, Zahir, Bader-Meunier, Brigitte, Antignac, Marie, Bardin, Nathalie, Belizna, Cristina, Belot, Alexandre, Bonnotte, Bernard, Bouaziz, Jean-David, Chasset, François, Chiche, Laurent, Cohen, Fleur, Costedoat-Chalumeau, Nathalie, Daugas, Eric, Devilliers, Hervé, Diot, Elisabeth, Elefant, Elisabeth, Faguer, Stanislas, Ferreira, Nicole, Hachulla, Eric, Hanslik, Thomas, Hie, Miguel, Jourde-Chiche, Noémie, Le Guern, Véronique, Martin, Thierry, Mathian, Alexis, Michel, Marc, Miyara, Makoto, Papo, Thomas, Richez, Christophe, Scherlinger, Marc, Sibilia, Jean, Uzunhan, Yurdagul, Wahl, Denis, Wojtasik, Géraldine, and Yelnik, Cécile

Published
2024
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6. Thrombosis recurrence and major bleeding in non-anticoagulated thrombotic antiphospholipid syndrome patients: Prospective study from antiphospholipid syndrome alliance for clinical trials and international networking (APS ACTION) clinical database and repository (“Registry”)

Author

Yelnik, Cecile M., Erton, Zeynep Belce, Drumez, Elodie, Cheildze, Dachi, de Andrade, Danieli, Clarke, Ann, Tektonidou, Maria G., Sciascia, Savino, Pardos-Gea, Jose, Pengo, Vittorio, Ruiz-Irastorza, Guillermo, Belmont, H. Michael, Pedrera, Chary Lopez, Fortin, Paul R., Wahl, Denis, Gerosa, Maria, Kello, Nina, Signorelli, Flavio, Atsumi, Tatsuya, Ji, Lanlan, Efthymiou, Maria, Branch, D. Ware, Nalli, Cecilia, Rodriguez-Almaraz, Esther, Petri, Michelle, Cervera, Ricard, Shi, Hui, Zuo, Yu, Artim-Esen, Bahar, Pons-Estel, Guillermo, Willis, Rohan, Barber, Megan R.W., Skeith, Leslie, Bertolaccini, Maria Laura, Cohen, Hannah, Roubey, Robert, and Erkan, Doruk

Published
2024
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9. Effect of weight-adjusted intermediate-dose versus fixed-dose prophylactic anticoagulation with low-molecular-weight heparin on venous thromboembolism among noncritically and critically ill patients with COVID-19: the COVI-DOSE trial, a multicenter, randomised, open-label, phase 4 trial

Author

Zuily, Stéphane, Couturaud, Francis, Goehringer, François, Laporte, Silvy, Mismetti, Patrick, Presles, Emilie, Rossignol, Patrick, Thilly, Nathalie, Wahl, Denis, Lecompte, Thomas, Oger, Emmanuel, Sevestre, Marie-Antoinette, Parent, Florence, Benhamou, Ygal, Roy, Pierre-Marie, Gigante, Tristan, Gilg, Morgane, Maclot, Pierre-Luc, Rossignol, Bénédicte, Udot, Jonathan, Bouteille, Hélène, Buchmuller, Andréa, Peurière, Céline, Siaghy, El Mehdi, Bouaziz, Valérie, Daguin, Charlotte, Grosjean, Benjamin, Saunier, Véronique, Verger, Laurence, Jacquot, Madlyne, Petitpain, Nadine, Charly, Martin, Tordella, Laurent, Baronnet, Guillaume, Baux, Elisabeth, Benetos, Athanase, Blanvillain, Jean-Baptiste, Conrad, Marie, Courte, Guilhem, Cravoisy-Popovic, Aurélie, Dufrost, Virginie, Gibot, Sébastien, Guerci, Philippe, Joly, Laure, Kimmoun, Antoine, Koszutski, Matthieu, Larue, Alexandrine, Levy, Bruno, Losser, Marie-Reine, Mattei, Mathieu, Nace, Lionel, Novy, Emmanuel, Perez, Pierre, Pertek, Jean-Pierre, Rigaux, Camille, Sauvage, Alexis, Schvoerer, Evelyne, Thivilier, Carine, Volkov, Lev, Zieminski, Piotr, Benlounes, Manil, Cheng, Charles, Fréminville, Jean-Baptiste de, Détriché, Grégoire, Flammarion, Emmanuel, Goudot, Guillaume, Hamdan, Amer, Hindré, Raphaël, Manoli, Corina, Messas, Emmanuel, Michon, Adrien, Mirault, Tristan, Pastré, Jean, Penet, Marie-Aude, Planquette, Benjamin, Volle, Geoffroy, Hamdan, Rémy, Laubriet-Jazayeri, Aline, Petit, Vincent, Piroth, Lionel, Quenot, Jean Pierre, Saccu, Mélissa, Barraud, Damien, Cavalli, Zoé, Gaci, Rostane, Andreu, Mathilde, Bertoletti, Laurent, De Magalhaes, Elodie, Bulifon, Sophie, Boucly, Athénaïs, Ebstein, Nathan, Humbert, Marc, Jaïs, Xavier, Jevnikar, Mitja, Savale, Laurent, Seferian, Andrei Horia, Colin, Charlotte, Ganem, Timothée, Roumila, Mehdi, Chopard, Romain, Besutti, Matthieu, Mouhat, Basile, Andrejak, Claire, Dupas, Stéphane, Le Roy, Gaëlle, Samy-Modeliar, Santhi, Coste, Anne, Fauche, Alexandre, Goetghebeur, David, Gut-Gobert, Christophe, Hoffmann, Clément, Hourmant, Baptiste, L'hévéder, Cécile, Lemoigne, Emmanuelle, Nepveu, Olivier, Paret, Raphaël, Picart, Gaël, Azerkan, Saïd, Boudaa, Chadia, Campagne, Julien, Eszto, Peter, Godbert, Benoît, Guichard, Jean-François, Heschung, Marion, Legoff, Antoine, Mariot, Jacques, Martin, Pascale, Mercy, Magalie, Perrin, Julie, Raymond, Stéphane, Vernier, Nathalie, Fesler, Pierre, Henneton, Pierrick, Mercuzot, Cédric, Pansu, Nathalie, Perez, Lucas, Andre, Loïc, Bakhache, Edgar, Chopin, Marie-Charlotte, Gilbert, Marie, Lambert, Marc, Pokeerbux, Mohammad Ryadh, Danion, François, Hansmann, Yves, Rougier, Estelle, Ruch, Yvon, Stéphan, Dominique, Ursenbach, Axel, Connerade, Isabelle, Gravier, Simon, Kayser, Damien, Michel, Jean-Marc, Mohseni, Mahsa, Younes, Waël, Burlacu, Ruxandra, Lopes, Amanda, Mouly, Stéphane, Nassarmadji, Kladoum, Sène, Damien, Siguret, Virginie, Stepanian, Alain, Annweiler, Cédric, Brangier, Antoine, Dubee, Vincent, Henni, Samir, Hersant, Jeanne, Loison, Jocelyne, Kern, Léa, Laine, Jean-Baptiste, Neveux-Brecheteau, Claire, Perez, Lucia, Benainous, Ruben, Giroux-Leprieur, Bénédicte, Lopez-Sublet, Marilucy, Khaled-Jousselin, Saïda, Bernard, Yohann, Amiot, Amélie, Breistroff, Jessica, Detry, Emilie, Diallo, Kadidiatou, Didier, Agnès, Dumont, Nathalie, Egensperger, Julie, Emmerich, Aurélie, François, Nelly, Gallo, Fanny, George, Valérie, Gérome, Quentin, Gutehrle, Aurélie, Lehman, Laure, Petit, Séverine, Piard, Vanessa, Saint-Gilles, Maximilien, Terenzi, Olivier, Marquette, Amélie, Mortelette, Hélène, Audry, Mathilde, Cransac, Amélie, Maillard, Marine, Boyer, Anaïs, Gallo, Floriana, Urbing, Arielle, Zahaf, Imane, Byczko, Alexandra, Chaalal, Amina, Berlier, Georgette, Bernabe, Corinne, Bezzeghoud, Souad, Chaudier, Caroline, Chauvet, Carole, Davier, Marina, Labruyere, Carine, Perrin, Estelle, Pierre, Michaël, Chekirine, Claire-Annissa, Voivret, Florence, Meftali, Ramdane, Sabri, Ouaffa, Beulaygue, Anaïs, Gall, Julie, Girard, Laure, Haddaoui, Soumia, Rami, Scheherazade, Couderc, Auriane, Le Breton, Aude, Perruche, Marie-Line, Claudon, Cindy, Roussel, Ludivine, Barnier, Aude, Blanchard, Tiphaine, Le Gall, Bénédicte, Pelouin, Mélanie, Veillon, Anne-Sophie, Aquereburu, Quam, Delaygue, Charlène, Ait Idir, Zahoua, Drugeon, Jérémy, Dubrulle, Déborah, Tezkratt, Rabah, Frantz, Anne-Sophie, Drouaine, Julie, Dubois, Jacqueline, Eyriey, Magali, Haerrel, Elina, Beaudenon, Mélinda, Guenet, Mialy, Lecerf, Thibaud, Marechal-Girault, Stéphanie, Rehaiem, Sami, Simon, Romain, Dangeul-Potier, Florence, Goulvent, Morgane, Fliss, Souha, Messani, Fadhila, Mizejewski, Béatrice, Mugnier, Brigitte, Opderbeck, Valérie, Risse, Brigitte, Lefèvre, Benjamin, Sanchez, Olivier, Empis de Vendin, Ombeline, de Ciancio, Guillaume, Arlet, Jean-Benoît, Khider, Lina, Terriat, Béatrice, Greigert, Hélène, Robert, Céline S., Louis, Guillaume, Trinh-Duc, Albert, Rispal, Patrick, Accassat, Sandrine, Thiery, Guillaume, Montani, David, Azarian, Réza, Meneveau, Nicolas, Soudet, Simon, Le Mao, Raphaël, Maurier, François, Le Moing, Vincent, Quéré, Isabelle, Yelnik, Cécile M., Lefebvre, Nicolas, Martinot, Martin, and Delrue, Maxime

Published
2023
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10. Associations Among Antiphospholipid Antibody Types, Isotypes, and Titers: An AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Study

Author

Pons-Estel, Guillermo, Giannakopoulos, Bill, Krilis, Steve, de Jesus, Guilherme, Levy, Roger, Signorelli, Flavio, Andrade, Danieli, Balbi, Gustavo, Clarke, Ann E., Skeith, Leslie, Fortin, Paul R., Ji, Lanlan, Zhang, Zhouli, Yang, Chengde, Shi, Hui, Zuily, Stephane, Wahl, Denis, Tektonidou, Maria G., Nalli, Cecilia, Andreoli, Laura, Tincani, Angela, Chighizola, Cecilia B., Gerosa, Maria, Meroni, Pierluigi, Pengo, Vittorio, Cheng, Chunyan, Pazzola, Giulia, Sciascia, Savino, Foddai, Silvia, Radin, Massimo, Davis, Stacy, Amengual, Olga, Atsumi, Tatsuya, Uthman, Imad, Limper, Maarten, Groot, Philip de, Ruiz—Irastorza, Guillermo, Ugarte, Amaia, Rodriguez-Pinto, Ignasi, Cervera, Ricard, Pardos-Gea, Jose, Rodriguez Almaraz, Esther, Cuadrado, Maria Jose, Aguirre Zamorano, Maria Angeles, Lopez-Pedrera, Chary, Artim-Esen, Bahar, Inanc, Murat, Bertolaccini, Maria Laura, Cohen, Hannah, Efthymiou, Maria, Khamashta, Munther, Mackie, Ian, Sanna, Giovanni, Knight, Jason, Zuo, Yu, Petri, Michelle, Leaf, Rebecca K., Roubey, Robert, Ortel, Thomas, Gonzalez, Emilio, Willis, Rohan, Kello, Nina, Belmont, Michael, Levine, Steven, Rand, Jacob, Barbhaiya, Medha, Erkan, Doruk, Salmon, Jane, Lockshin, Michael, Duarte Garcia, Ali A., Branch, D. Ware, Gkrouzman, Elena, Ruiz-Irastorza, Guillermo, Belmont, H. Michael, Rodriguez-Almaraz, Esther, Petri, Michelle A., and Knight, Jason S.

Published
2023
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11. Precipitating factors of catastrophic antiphospholipid syndrome: the role of anticoagulant treatment in a series of 112 patients

Author

Stammler, Romain, Nguyen, Yann, Yelnik, Cécile, Le Guern, Véronique, Lambert, Marc, Paule, Romain, Hachulla, Eric, Mouthon, Luc, Dupré, Anastasia, Ackermann, Félix, Dufrost, Virginie, Wahl, Denis, Godeau, Bertrand, Leroux, Gaëlle, Benhamou, Ygal, Lazaro, Estibaliz, Daugas, Eric, Bezanahary, Holy, Mekinian, Arsène, Piette, Jean-Charles, Morel, Nathalie, and Costedoat-Chalumeau, Nathalie

Published
2023
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12. Frequency and predictors for chronic thromboembolic pulmonary hypertension after a first unprovoked pulmonary embolism: Results from PADIS studies

Author

Fauché, Alexandre, Presles, Emilie, Sanchez, Olivier, Jaïs, Xavier, Le Mao, Raphael, Robin, Philippe, Pernod, Gilles, Bertoletti, Laurent, Jego, Patrick, Parent, Florence, Lemarié, Catherine A., Leven, Florent, Le Roux, Pierre‐Yves, Salaun, Pierre‐Yves, Nonent, Michel, Girard, Philippe, Lacut, Karine, Savale, Laurent, Mélac, Solen, Guégan, Marie, Mismetti, Patrick, Laporte, Silvy, Leroyer, Christophe, Montani, David, Couturaud, Francis, Tromeur, Cécile, Meyer, Guy, Duhamel, Elisabeth, Provost, Karine, Mottier, Dominique, Le Hir, Aurélia, Lenoir, Stéphane, Lamer, Christian, Bergmann, Jean François, Wahl, Denis, Drouet, Ludovic, Chevarier, Patrick, Monte, Nicolas, Morvan, Florence, Kouassi, Véronique, Ibrir, Nabahats, El Asri, Gaid, Salaun, Pierre Yves, Le Roux, Pierre Yves, Bressollette, Luc, Quéhé, Philippe, Gestin, Simon, Bahuon, Jérôme, Deloire, Lucille, Planquette, Benjamin, Jobic, Yannick, Etienne, Yves, Didier, Romain, Leroux, Loic, Galinat, Hubert, Le Maréchal, Cédric, Gourhant, Lénaïck, Mingant, Fanny, Lemoigne, Emmanuelle, De Saint Martin, Luc, Delluc, Aurélien, Le Gal, Grégoire, Paleiron, Nicolas, Le Mao, Raphaël, Pison, Christophe, Guéret, Philippe, Décousus, Hervé, and Accassat, Sandrine

Published
2022
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23. Cardiovascular and connective tissue disorder features in FLNA-related PVNH patients: progress towards a refined delineation of this syndrome

Author

Billon, Clarisse, Adham, Salma, Hernandez Poblete, Natalia, Legrand, Anne, Frank, Michael, Chiche, Laurent, Zuily, Stephane, Benistan, Karelle, Savale, Laurent, Zaafrane-Khachnaoui, Khaoula, Brehin, Anne-Claire, Bal, Laurence, Busa, Tiffany, Fradin, Mélanie, Quelin, Chloé, Chesneau, Bertrand, Wahl, Denis, Fergelot, Patricia, Goizet, Cyril, Mirault, Tristan, Jeunemaitre, Xavier, and Albuisson, Juliette

Published
2021
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25. Development of a New International Antiphospholipid Syndrome Classification Criteria Phase I/II Report: Generation and Reduction of Candidate Criteria

Author

Barbhaiya, Medha, Zuily, Stephane, Ahmadzadeh, Yasaman, Amigo, Mary‐Carmen, Avcin, Tadej, Bertolaccini, Maria Laura, Branch, D. Ware, de Jesus, Guilherme, Devreese, Katrien M. J., Frances, Camille, Garcia, David, Guillemin, Francis, Levine, Steven R., Levy, Roger A., Lockshin, Michael D., Ortel, Thomas L., Seshan, Surya V., Tektonidou, Maria, Wahl, Denis, Willis, Rohan, Naden, Ray, Costenbader, Karen, Erkan, Doruk, Agmon‐Levin, Nancy, Aguilar, Cassyanne, Alba, Paula, Alpan, Oral, Ambrozic, Ales, Amoura, Zahir, Andrade, Danieli, Andrade, Luis, Appenzeller, Simone, Esen, Bahar Artim, Atsumi, Tatsuya, Berkun, Yackov, Cabral, Antonio, Canaud, Guillaume, Cervera, Ricard, Chen, Pojen, Chighizola, Cecilia, Cimaz, Rolando, Cohen, Hannah, Costedoat‐Chalumeau, Nathalie, Crowther, Mark, Cuadrado, Maria Jose, de Groot, Philip G., de Moerloose, Philippe, Derksen, Ronald, Diz‐Kucukkaya, Reyhan, Dörner, Thomas, Fortin, Paul, Giannakopoulos, Bill, Gómez‐Puerta, Jose A., Gonzalez, Emilio B., Inanc, Murat, Kenet, Gili, Khamashta, Munther, Kriegel, Martin, Krilis, Steven, Laskin, Carl, Massicotte, Patti, McCarty, Gale, Meroni, Pier Luigi, Mikdashi, Jamal, Myones, Barry, Pengo, Vittorio, Petri, Michelle, Roubey, Robert, Sammaritano, Lisa, Sanna, Giovanni, Sciascia, Savino, Signorelli, Flavio, Soybilgic, Arzu, Tincani, Angela, Woller, Scott, and Yelnik, Cécile

Published
2021
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33. Health-related quality of life, remission and low lupus disease activity state in patients with systemic lupus erythematosus.

Author

Thibault, Thomas, Rajillah, Abdessamad, Bourredjem, Abderrahmane, Corneloup, Marie, Maurier, François, Wahl, Denis, Muller, Geraldine, Aumaitre, Olivier, Sève, Pascal, Blaison, Gilles, Besancenot, Jean-François, Martin, Thierry, Magy-Bertrand, Nadine, Samson, Maxime, Arnaud, Laurent, Amoura, Zahir, Devilliers, Hervé, and Group, the EQUAL Study

Subjects
REPEATED measures design, RESEARCH funding, QUESTIONNAIRES, DISEASE remission, SEVERITY of illness index, SYSTEMIC lupus erythematosus, HEALTH surveys, DESCRIPTIVE statistics, LONGITUDINAL method, QUALITY of life, MEDICAL appointments, HEALTH outcome assessment, PATIENT aftercare
Abstract

Objectives To measure the association between SLE remission and scores of patients-reported outcome (PRO) measures. Methods We performed a prospective cohort study of SLE patients with a 2-year follow-up, using Lupus Patient-Reported Outcome (LupusPRO), Lupus Quality of Life (LupusQoL), Systemic Lupus Erythematosus Quality of Life (SLEQOL) and 36-item Short Form (SF-36) questionnaires. Remission was defined as remission off treatment (ROFT) and remission on treatment (RONT) according to the definitions of remission in SLE consensus. Mixed models accounting for repeated measures were used to compare groups as follow: ROFT and RONT vs no remission and lupus low disease activity state (LLDAS) vs no LLDAS. Results A total of 1478 medical visits and 2547 PRO questionnaires were collected during the follow-up from the 336 recruited patients. A between-group difference in PRO scores reaching at least 5 points on a 0–100 scale was obtained in the following domains: lupus symptoms (LLDAS: +5 points on the 0–100 scale, RONT: +9, ROFT: +5), lupus medication (LLDAS: +5, RONT: +8, ROFT: +9), pain vitality (LLDAS: +6, RONT: +9, ROFT: +6) of LupusPRO; role emotional (LLDAS: +5, RONT: +8), role physical (RONT: +7 and ROFT: +7), bodily pain (RONT: +6), mental health (RONT: +5) and social functioning (RONT: +6) of SF-36. In contrast, a between-group difference reaching at least 5 points was not achieved for any of the LupusQoL and SLEQOL domains. Conclusions RONT, ROFT and LLDAS were associated with significant and clinically relevant higher QoL in most PRO domains of the LupusPRO (disease specific) and SF-36 (generic) questionnaires, but not with LupusQoL and SLEQOL disease-specific questionnaires. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Damage measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody-positive patients included in the APS ACTION registry.

Author

Balbi, Gustavo G M, Ahmadzadeh, Yasaman, Tektonidou, Maria G, Pengo, Vittorio, Sciascia, Savino, Ugarte, Amaia, Belmont, H Michael, Lopez-Pedrera, Chary, Fortin, Paul R, Wahl, Denis, Gerosa, Maria, Jesús, Guilherme R de, Ji, Lanlan, Atsumi, Tatsuya, Efthymiou, Maria, Branch, D Ware, Nalli, Cecilia, Almaraz, Esther Rodriguez, Petri, Michelle, and Cervera, Ricard

Subjects
THROMBOSIS, CLINICAL pathology, HYPERTENSION, CARDIOVASCULAR diseases risk factors, AUTOANTIBODIES, REPORTING of diseases, CONFIDENCE intervals, ADRENOCORTICAL hormones, ANTIPHOSPHOLIPID syndrome, CROSS-sectional method, AUTOIMMUNE diseases, ANTICOAGULANTS, HYPERLIPIDEMIA, SYMPTOMS, DESCRIPTIVE statistics, ODDS ratio
Abstract

Objectives Our primary objective was to quantify damage burden measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in aPL-positive patients with or without a history of thrombosis in an international cohort (the APS ACTION cohort). Secondly, we aimed to identify clinical and laboratory characteristics associated with damage in aPL-positive patients. Methods In this cross-sectional study, we analysed the baseline damage in aPL-positive patients with or without APS classification. We excluded patients with other autoimmune diseases. We analysed the demographic, clinical and laboratory characteristics based on two subgroups: (i) thrombotic APS patients with high vs low damage; and (ii) non-thrombotic aPL-positive patients with vs without damage. Results Of the 826 aPL-positive patients included in the registry as of April 2020, 586 with no other systemic autoimmune diseases were included in the analysis (412 thrombotic and 174 non-thrombotic). In the thrombotic group, hyperlipidaemia (odds ratio [OR] 1.82; 95% CI 1.05, 3.15; adjusted P  = 0.032), obesity (OR 2.14; 95% CI 1.23, 3.71; adjusted P  = 0.007), aβ2GPI high titres (OR 2.33; 95% CI 1.36, 4.02; adjusted P  = 0.002) and corticosteroid use (ever) (OR 3.73; 95% CI 1.80, 7.75; adjusted P  < 0.001) were independently associated with high damage at baseline. In the non-thrombotic group, hypertension (OR 4.55; 95% CI 1.82, 11.35; adjusted P  = 0.001) and hyperlipidaemia (OR 4.32; 95% CI 1.37, 13.65; adjusted P  = 0.013) were independent predictors of damage at baseline; conversely, single aPL positivity was inversely correlated with damage (OR 0.24; 95% CI 0.075, 0.77; adjusted P  = 0.016). Conclusions DIAPS indicates substantial damage in aPL-positive patients in the APS ACTION cohort. Selected traditional cardiovascular risk factors, steroids use and specific aPL profiles may help to identify patients more prone to present with a higher damage burden. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Viewpoint: Provoked thrombosis in antiphospholipid syndrome.

Author

Wahl, Denis and Pengo, Vittorio

Subjects
*THROMBOEMBOLISM risk factors, *CARDIOVASCULAR diseases risk factors, *VEINS, *STROKE, *ANTIPHOSPHOLIPID syndrome, *ANTICOAGULANTS, *DISEASE relapse, *THROMBOEMBOLISM, *GLYCOPROTEINS, *SYSTEMIC lupus erythematosus, *DISEASE complications
Abstract

Unprovoked thrombosis (thrombosis occurring without an established environmental factor favouring the episode) is a classic feature of APS. In the general population, provoked venous thromboembolism (VTE) is clearly defined and has clinical and therapeutic differences compared with unprovoked VTE. Whether provoked VTE in the context of APS may lead to a limited treatment duration is not well established. Therefore, careful clinical and laboratory evaluation is needed to identify patients eligible for a limited duration of anticoagulation treatment after provoked VTE. Given the uncertainties of available data, the risks and benefits of treatment decisions should be clearly explained. Decisions should be shared by both the patient and physician. Cardiovascular risk factors are common in patients with APS with arterial thrombosis. There are insufficient data suggesting that cardiovascular risk factor control would allow the cessation of anticoagulation. In most instances, arterial thrombosis will require prolonged anticoagulants. A careful analysis of clinical characteristics and laboratory evaluation, particularly the aPL antibody profile, is needed to make decisions on a case-by-case basis. [ABSTRACT FROM AUTHOR]

Published
2024
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36. The relevance of “non-criteria” clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features

Author

Abreu, Mirhelen M., Danowski, Adriana, Wahl, Denis G., Amigo, Mary-Carmen, Tektonidou, Maria, Pacheco, Marcelo S., Fleming, Norma, Domingues, Vinicius, Sciascia, Savino, Lyra, Julia O., Petri, Michelle, Khamashta, Munther, and Levy, Roger A.

Published
2015
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46. The mediating effect of fatigue in impaired quality of life in systemic lupus erythematosus: mediation analysis of the French EQUAL cohort.

Author

Thibault, Thomas, Bourredjem, Abderrahmane, Maurier, François, Wahl, Denis, Muller, Geraldine, Aumaitre, Olivier, Sève, Pascal, Blaison, Gilles, Pennaforte, Jean-Loup, Martin, Thierry, Magy-Bertrand, Nadine, Audia, Sylvain, Arnaud, Laurent, Amoura, Zahir, Devilliers, Hervé, and Group, for the EQUAL Study

Subjects
MUSCULOSKELETAL system diseases, RESEARCH, HEALTH outcome assessment, HEALTH surveys, PATIENTS' attitudes, ATTITUDES toward illness, QUALITY of life, SYMPTOMS, FACTOR analysis, CENTER for Epidemiologic Studies Depression Scale, MENTAL depression, RESEARCH funding, QUESTIONNAIRES, SOCIAL classes, SYSTEMIC lupus erythematosus, FATIGUE (Physiology), LONGITUDINAL method, DISEASE risk factors, DISEASE complications
Abstract

Objectives Mediation analyses were conducted to measure the extent to which musculoskeletal (MSK) flares and depression affected physical health through excessive fatigue. Methods Mediation analyses were performed in a large multicentre cohort of SLE patients. Domains of the LupusQoL and SLEQOL questionnaires were selected as outcomes, MSK flares according to the SELENA-SLEDAI flare index (SFI-R) score and depression defined by Center for Epidemiologic Studies-Depression scale (CES-D) scale as exposures and different fatigue domains from MFI-20 and LupusQoL questionnaires as mediators. For each model, total, direct, indirect effects and proportion of effect mediated by fatigue (i.e. proportion of change in health-related quality of life) were determined. Results Of the 336 patients, 94 (28%) had MSK flares at inclusion and 99 (29.5%) were considered with depression. The proportion of the total effect of MSK flares on physical health impairment explained by fatigue ranged from 59.6% to 78% using the LupusQOL 'Physical health' domain and from 51.1% to 73.7% using the SLEQOL 'Physical functioning' domain, depending on the fatigue domain selected. The proportion of the total effect of depression on physical health impairment explained by fatigue ranged from 68.8% to 87.6% using the LupusQOL 'Physical health' domain and from 79.3% to 103.2% using the SLEQOL 'Physical functioning' domain, depending on the fatigue domain selected. Conclusions The effect of MSK flares and depression on physical health impairment is largely mediated by fatigue. Thus, the patient's perception of disease activity as measured by physical health is largely influenced by fatigue. In addition, fatigue has a significant negative impact on quality of lifeof SLE patients with depression. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov , NCT01904812. [ABSTRACT FROM AUTHOR]

Published
2023
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