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3. Venous recanalisation in the setting of post-thrombotic syndrome: An expert consensus from the French Society of Vascular Medicine (SFMV) and the French Society of Cardiovascular Imaging and Interventional Radiology (SFICV)

Author

Del Giudice, Costantino, Mahe, Guillaume, Thony, Frederic, Zuily, Stephane, Goyault, Gilles, Diard, Antoine, Loffroy, Romaric, Galanaud, Jean-Philippe, Thouveny, Francine, Quere, Isabelle, Menez, Caroline, Jurus, Christine, Pernod, Gilles, Pernes, Jean-Marc, and Sapoval, Marc

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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15. Anticoagulant interventions in hospitalized patients with COVID‐19: A scoping review of randomized controlled trials and call for international collaboration

Author

Tritschler, Tobias, Mathieu, Marie‐Eve, Skeith, Leslie, Rodger, Marc, Middeldorp, Saskia, Brighton, Timothy, Sandset, Per Morten, Kahn, Susan R., Angus, Derek C., Blondon, Marc, Bonten, Marc J., Cattaneo, Marco, Cushman, Mary, Derde, Lennie P.G., DeSancho, Maria T., Diehl, Jean‐Luc, Goligher, Ewan, Jilma, Bernd, Jüni, Peter, Lawler, Patrick R., Marietta, Marco, Marshall, John C., McArthur, Colin, Miranda, Carlos Henrique, Mirault, Tristan, Morici, Nuccia, Perepu, Usha, Schörgenhofer, Christian, Sholzberg, Michelle, Spyropoulos, Alex C., Webb, Steve A., Zarychanski, Ryan, Zuily, Stéphane, and Le Gal, Grégoire

Published
2020
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17. 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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19. 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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21. The 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria.

Author

Barbhaiya, Medha, Zuily, Stephane, Naden, Ray, Hendry, Alison, Manneville, Florian, Amigo, Mary‐Carmen, Amoura, Zahir, Andrade, Danieli, Andreoli, Laura, Artim‐Esen, Bahar, Atsumi, Tatsuya, Avcin, Tadej, Belmont, H. Michael, Bertolaccini, Maria Laura, Branch, D. Ware, Carvalheiras, Graziela, Casini, Alessandro, Cervera, Ricard, Cohen, Hannah, and Costedoat‐Chalumeau, Nathalie

Subjects
*AUTOANTIBODY analysis, *CONSENSUS (Social sciences), *IMMUNOGLOBULINS, *ANTIPHOSPHOLIPID syndrome, *DECISION making, *THROMBOEMBOLISM, *ENZYME-linked immunosorbent assay, *HEALTH care teams, *SENSITIVITY & specificity (Statistics), *DELPHI method
Abstract

Objective: To develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR. Methods: This international multidisciplinary initiative included 4 phases: 1) Phase I, criteria generation by surveys and literature review; 2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; 3) Phase III, criteria definition, further reduction with the guidance of real‐world patient scenarios, and weighting via consensus‐based multicriteria decision analysis, and threshold identification; and 4) Phase IV, validation using independent adjudicators' consensus as the gold standard. Results: The 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL‐associated clinical criterion, followed by additive weighted criteria (score range 1–7 points each) clustered into 6 clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and 2 laboratory domains (lupus anticoagulant functional coagulation assays, and solid‐phase enzyme‐linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti–β2‐glycoprotein I antibodies). Patients accumulating at least 3 points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria versus the 2006 revised Sapporo classification criteria had a specificity of 99% versus 86%, and a sensitivity of 84% versus 99%. Conclusion: These new ACR/EULAR APS classification criteria were developed using rigorous methodology with multidisciplinary international input. Hierarchically clustered, weighted, and risk‐stratified criteria reflect the current thinking about APS, providing high specificity and a strong foundation for future APS research. [ABSTRACT FROM AUTHOR]

Published
2023
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22. 2023 ACR/EULAR antiphospholipid syndrome classification criteria.

Author

Barbhaiya, Medha, Zuily, Stephane, Naden, Ray, Hendry, Alison, Manneville, Florian, Amigo, Mary-Carmen, Amoura, Zahir, Andrade, Danieli, Andreoli, Laura, Artim-Esen, Bahar, Tatsuya Atsumi, Avcin, Tadej, Belmont, Michael H., Bertolaccini, Maria Laura, Branch, D. Ware, Carvalheiras, Graziela, Casini, Alessandro, Cervera, Ricard, Cohen, Hannah, and Costedoat-Chalumeau, Nathalie

Published
2023
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23. Review article: Risk of cardiovascular events in patients with inflammatory bowel disease receiving small molecule drugs.

Author

Olivera, Pablo A., Lasa, Juan S., Peretto, Giovanni, Zuily, Stephane, Danese, Silvio, and Peyrin‐Biroulet, Laurent

Subjects
INFLAMMATORY bowel diseases, CARDIOVASCULAR diseases risk factors, SMALL molecules, ANGIOTENSIN II, HERBICIDE resistance
Abstract

Summary: Background: In the context of an ageing inflammatory bowel disease (IBD) population, cardiovascular comorbidities become particularly relevant. Novel small molecule drugs (SMDs) for the treatment of moderate‐to‐severe IBD have been recently approved, including Janus kinase (JAK) inhibitors and sphingosine‐1‐phosphate receptor (S1P) modulators. Data from rheumatoid arthritis population have raised concerns about the risk of cardiovascular events with the use of tofacitinib, which was extrapolated to other immune‐mediated diseases and other JAK inhibitors. S1P receptor modulation has been associated with potential cardiovascular events, especially bradycardia and cardiac conduction abnormalities. Aim: To review the incidence of cardiovascular events with the use of SMDs in patients with IBD and to provide practical recommendations on mitigation strategies. Methods: Published literature was reviewed; recommendations were synthesised by experts in both cardiovascular diseases and IBD. Results: Evidence from the IBD population does not indicate a higher risk of cardiovascular events with tofacitinib and other JAK inhibitors. The risk is higher in patients with intermediate to high cardiovascular risk. S1P modulators may be associated with a dose‐dependent, first‐dose effect, transient risk of conduction abnormalities (bradycardia and AV block). Screening and monitoring of cardiovascular risk factors should be done in all patients with IBD. Risk stratification for cardiovascular disease should be performed before starting treatment with SMDs. Conclusions: Available evidence of both JAK inhibitors and S1P modulators indicates a reassuring safety profile of SMDs from the cardiovascular perspective in the overall IBD population. Efforts should be made to identify patients with IBD at a higher risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Published
2023
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30. COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION)

Author

Wang, Xin Gkrouzman, Elena Andrade, Danieli Castro Oliveira and Andreoli, Laura Barbhaiya, Medha Belmont, H. Michael Branch, David Ware de Jesus, Guilherme R. Efthymiou, Maria and Rios-Garces, Roberto Gerosa, Maria El Hasbani, Georges and Knight, Jason Meroni, Pier Luigi Pazzola, Giulia Petri, Michelle Rand, Jacob Salmon, Jane Tektonidou, Maria and Tincani, Angela Uthman, Imad W. Zuily, Stephane Zuo, Yu and Lockshin, Michael Cohen, Hannah Erkan, Doruk APS ACTION

Subjects
immune system diseases, neoplasms
Abstract

Coronavirus disease 2019 (COVID-19) is associated with a high rate of thrombosis. Prolonged activated partial thromboplastin times (aPTT) and antiphospholipid antibodies (aPL) are reported in COVID-19 patients. The majority of publications have not reported whether patients develop clinically relevant persistent aPL, and the clinical significance of new aPL-positivity in COVID-19 is currently unknown. However, the reports of aPL-positivity in COVID-19 raised the question whether common mechanisms exist in the pathogenesis of COVID-19 and antiphospholipid syndrome (APS). In both conditions, thrombotic microangiopathy resulting in microvascular injury and thrombosis is hypothesized to occur through multiple pathways, including endothelial damage, complement activation, and release of neutrophil extracellular traps (NETosis). APS-ACTION, an international APS research network, created a COVID-19 working group that reviewed common mechanisms, positive aPL tests in COVID-19 patients, and implications of COVID-19 infection for patients with known aPL positivity or APS, with the goals of proposing guidance for clinical management and monitoring of aPL-positive COVID-19 patients. This guidance also serves as a call and focus for clinical and basic scientific research.

Published
2021

31. Reply.

Author

Barbhaiya, Medha, Zuily, Stephane, Hendry, Alison, Manneville, Florian, Guillemin, Francis, Costenbader, Karen, and Erkan, Doruk

Subjects
*ANTIPHOSPHOLIPID syndrome treatment, *DECISION making in clinical medicine, *RHEUMATOLOGY, *EVIDENCE-based medicine, *ANTIPHOSPHOLIPID syndrome
Published
2024
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35. new pro-thrombotic mechanism of neutrophil extracellular traps in antiphospholipid syndrome: impact on activated protein C resistance.

Author

Foret, Thomas, Dufrost, Virginie, Mont, Lucie Salomon du, Costa, Patricia, Lakomy, Cecile, Lagrange, Jeremy, Lacolley, Patrick, Regnault, Veronique, Zuily, Stephane, and Wahl, Denis

Subjects
THROMBOSIS risk factors, AUTOANTIBODY analysis, DNA, BLOOD coagulation tests, ANTIPHOSPHOLIPID syndrome, CROSS-sectional method, CLASSIFICATION, AUTOIMMUNE diseases, PATIENTS, PEROXIDASE, ACTIVATED protein C resistance, ENZYME-linked immunosorbent assay, EXTRACELLULAR space, NUCLEIC acids, DISEASE complications, BLOOD
Abstract

Objectives In APS, precise evaluation of thrombotic risk is a major challenge. Different players, such as activated protein C (APC) resistance or neutrophil extracellular traps (NETs) contribute to the risk of thrombosis. Nevertheless, no study has investigated the interaction between these actors. The main objective of this study was to investigate the relation between NETs and APC resistance. Methods We designed a cross-sectional study including APS/antiphospholipid antibodies (aPL) patients and patients with autoimmune diseases (AID). We performed thrombin generation tests without and with APC to determine APC resistance. To evaluate circulating NETs, we measured plasma levels of MPO-DNA complexes and cell-free DNA with ELISA. Results We recruited 117 patients with definite APS/aPL or AID. We found a positive correlation between NETs and APC resistance, in APS patients and specifically in patients with high thrombotic risk, displaying LA or positivity of all three aPL tests (triple+), or anti-domain I IgG (aDI+). All these patient subgroups had increased NETs concentrations and APC resistance. As the risk profile for thrombosis increased, the relationship between NETs and APC resistance was stronger. Conclusion We have shown that NETs participate in the hypercoagulable state of APS patients by contributing to APC resistance, in particular in high-risk patients. In these most at-risk patients, a targeted action on NETs could reduce APC resistance and constitute a new therapeutic approach in the treatment of APS patients in addition to antithrombotic therapy. [ABSTRACT FROM AUTHOR]

Published
2022
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40. Impact of antiphospholipid syndrome iBook on medical students' improvement of knowledge: An international randomized controlled study.

Author

Zuily, Stephane, Phialy, Laurent, Sevim, Ecem, Germain, Eloïse, Unlu, Ozan, Dufrost, Virginie, Risse, Jessie, Clerc-Urmès, Isabelle, Baumann, Cédric, Berman, Jessica R., Lockshin, Michael D., Wahl, Denis, and Erkan, Doruk

Subjects
*MEDICAL students, *ANTIPHOSPHOLIPID syndrome, *PRINT materials, *TEACHING methods, *BIOMEDICAL materials
Abstract

Objective: iBook on Antiphospholipid Syndrome (APS) did not exist before our work, and hence the utility of an Apple iBook as a teaching method in APS for medical students has never been assessed. Our objective was to evaluate medical students' improvement of knowledge and satisfaction with an interactive APS iBook, in comparison with conventional teaching methods. Methods: An iBook designer with the guidance of a medical team developed the APS iBook in both French and English. Second-year medical students, naive of APS knowledge, were enrolled from two institutions. For the "teaching intervention", participants were randomly assigned to three groups: a) APS iBook with interactive capability; b) printed copy of the APS iBook material; and c) classroom lecture presentation of the APS iBook material by a physician-scientist experienced in APS. The participants filled a standardized medical questionnaire about APS before and after teaching interventions to determine the relative change of knowledge. Participants were asked to fill out a standardized satisfaction survey. After 20 weeks of the intervention, recall capability of students was tested. Results: A total of 233 second-year medical students were enrolled (iBook group: 73; print group: 79, and lecture group: 81). Relative change of knowledge was not different between the iBook group and the printed material group; additionally, it was significantly higher in the lecture group than the two other methods. Satisfaction was significantly higher in both the lecture and the iBook groups than the print group, on several dimensions including overall quantitative satisfaction, subjective enhanced knowledge, interactivity, quality of content, comprehensibility, and pleasure of learning. Recall capability of students (n=109, 47%) was not significantly different among groups. Conclusion: The APS iBook is as effective as printed material in improving medical student's knowledge, although a classroom lecture was the most effective method when compared to self-learning methods. Among self-learning methods, medical students are more satisfied with the APS iBook, whereas the recall capability was not different among groups. These results suggest that the APS iBook will help medical students in their curriculum and increase the awareness of APS among the community. [ABSTRACT FROM AUTHOR]

Published
2019
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48. The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus.

Author

Ünlü, Ozan, Zuily, Stephane, and Erkan, Doruk

Subjects
*PHOSPHOLIPID antibodies, *SYSTEMIC lupus erythematosus
Abstract

Antiphospholipid syndrome (APS) is the association of thrombosis and/or pregnancy morbidity with antiphospholipid antibodies (aPL). Thirty to forty percent of systemic lupus erythematosus (SLE) patients are tested positive for aPL, which may have an impact on the SLE presentation, management, and prognosis. Compared with SLE patients without aPL, those with aPL have a higher prevalence of thrombosis, pregnancy morbidity, valve disease, pulmonary hypertension, livedo reticularis, thrombocytopenia, hemolytic anemia, acute/ chronic renal vascular lesions, and moderate/severe cognitive impairment; worse quality of life; and higher risk of organ damage. The use of low-dose aspirin (LDA) is controversial for primary thrombosis and pregnancy morbidity prevention because of the lack of strong prospective controlled data. Similarly, the use of anticoagulation is controversial for patients with an aPL-related nephropathy. Until further studies are available, physicians should discuss the risk/benefits of LDA or anticoagulation as well as the available literature with patients. [ABSTRACT FROM AUTHOR]

Published
2016
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50. Variability in Exposure of Epitope G40-R43 of Domain I in Commercial Anti-Beta2-Glycoprotein I IgG ELISAs.

Author

Pelkmans, Leonie, Kelchtermans, Hilde, de Groot, Philip G., Zuily, Stephane, Regnault, Veronique, Wahl, Denis, Pengo, Vittorio, and de Laat, Bas

Subjects
EPITOPES, GLYCOPROTEINS, BLOOD coagulation disorders, ANTIPHOSPHOLIPID syndrome, IMMUNOGLOBULINS, GLYCINE
Abstract

Background: A major problem for diagnosing the antiphospholipid syndrome (APS) is the high variability between commercial anti-β2glycoprotein I (β2GPI) assays. Predominantly antibodies reactive against cryptic epitope Glycine40-Arginine43 (G40-R43) in domain I are associated with an increased risk for thrombosis. Upon interaction with anionic surfaces β2GPI opens up, thereby exposing G40-R43. Objectives: To examine whether suboptimal exposure of epitope G40-R43 explains the variations in results observed between commercial assays. Methods: Two patient-derived monoclonal antibodies were tested on neutral versus anionic plates. Antibody P1-117 reacts with G40-R43 in the open conformation while P2-6 recognizes β2GPI irrespective of its conformation. These antibodies were tested in commercial anti-β2GPI assays (A–E). Results: In assay A, both antibodies showed equal reactivity towards β2GPI, indicating that all the β2GPI exposes G40-R43. In other assays P1-117 displayed lower reactivity than P2-6, demonstrating reduced G40-R43 availability. To exclude influences of other assay features, reactivity was re-examined on plates of assay A and B using the protocol/reagents from each assay. In all combinations, reactivity of both antibodies on a plate was comparable to results obtained with its own protocol/reagents, suggesting that the coating, rather than other assay components, accounts for the observed differences. In two patient cohorts we demonstrated that a number of domain I-reactive samples are missed in assays characterized by a decreased exposure of epitope G40-R43. Conclusions: Exposure of epitope G40-R43 on β2GPI is highly variable between commercial anti-β2GPI assays. As a consequence, patients can be falsely assigned negative in assays characterized by a reduced exposure of G40-R43. [ABSTRACT FROM AUTHOR]

Published
2013
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