TY - JOUR T1 - Association of antiphospholipid antibodies with active digital ulceration in systemic sclerosis JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2019-001012 VL - 5 IS - 2 SP - e001012 AU - Mickaël Martin AU - Camille Martinez AU - Laurent Arnaud AU - Jean-Christophe Weber AU - Vincent Poindron AU - Gilles Blaison AU - Pierre Kieffer AU - Bernard Bonnotte AU - Sabine Berthier AU - Denis Wahl AU - Francois Maurier AU - Jean-Loup Pennaforte AU - Philip Bielefeld AU - Nadine Magy-Bertrand AU - Hervé Devilliers AU - Thierry Martin Y1 - 2019/09/01 UR - http://rmdopen.bmj.com/content/5/2/e001012.abstract N2 - Key messagesWhat is already known about this subject?Antiphospholipid antibodies (aPL) prevalence seemed increased in patients with systemic sclerosis (SSc), but their clinical signification is unclear.What does this study add?Description of aPL positivity and antiphospholipid syndrome prevalence in a multicentre cross-sectional SSc cohort (confirmed and high aPL titre level).Anti-beta-2 glycoprotein 1 (β2GP1) positivity is an independent factor associated with active digital ulceration.How might this impact on clinical practice?aPL and especially anti-β2GP1 should be screened in SSc to detect patients potentially at higher risk of developing digital ulcers.Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) can be severe with active digital ulceration (ADU) and gangrene. RP physiopathology includes early endothelial cell injury, vascular dysfunction and sometimes microvascular thrombosis.1 Antiphospholipid antibodies (aPL) activate endothelial cells and platelets by complexes of beta-2 glycoprotein 1 (β2GP1) and anti-β2GP12 and could therefore contribute to the initiation of and/or aggravate SSc-related RP. aPL prevalence seems increased in patients with SSc compared with controls,3 but aPL-associated clinical features are often contradictory. The aims of this study were to assess aPL and antiphospholipid syndrome (APS) prevalence in patients with SSc and their association with ADU.Consecutive patients aged more than 18 years, fulfilling the American College of Rheumatology/EULAR classification criteria for SSc4 and followed in seven French expert centres for autoimmune diseases labelled by the French national network for autoimmune disease care, were enrolled prospectively during 8 months. Patients with other associated autoimmune disease were excluded. All patients provided written informed consent. SSc subtype was classified based on LeRoy and Medsger’s criteria,5 and skin involvement was assessed according to the modified Rodnan skin score (mRSS).6 Interstitial lung disease … ER -