PT  - JOURNAL ARTICLE
AU  - Noemie Abisror
AU  - Yann Nguyen
AU  - Luca Marozio
AU  - Enrique Esteve Valverde
AU  - Sebastian Udry
AU  - Daniel Enrique Pleguezuelo
AU  - Paul Billoir
AU  - Karoline Mayer-Pickel
AU  - Geoffrey Urbanski
AU  - Polona Zigon
AU  - Claire De Moreuil
AU  - Ariela Hoxha
AU  - Holy Bezanahary
AU  - Lionel Carbillon
AU  - Gilles Kayem
AU  - Marie Bornes
AU  - Cecile Yelnik
AU  - Cathererine Johanet
AU  - Pascale Nicaise-Roland
AU  - Marc Lambert
AU  - Valéry Salle
AU  - Omar Jose Latino
AU  - Eric Hachulla
AU  - Chiara Benedetto
AU  - Marie Charlotte Bourrienne
AU  - Ygal Benhamou
AU  - Jaume Alijotas-Reig
AU  - Olivier Fain
AU  - Arsène Mekinian
AU  - On behalf of European Forum on Antiphospholipid Antibodies
TI  - Obstetrical outcome and treatments in seronegative primary APS: data from European retrospective study
AID  - 10.1136/rmdopen-2020-001340
DP  - 2020 Aug 01
TA  - RMD Open
PG  - e001340
VI  - 6
IP  - 2
4099  - http://rmdopen.bmj.com/content/6/2/e001340.short
4100  - http://rmdopen.bmj.com/content/6/2/e001340.full
SO  - RMD Open2020 Aug 01; 6
AB  - Objective To compare characteristics, pregnancies and treatments during pregnancies of seronegative and seropositive antiphospholipid syndrome (APS), to analyse factors associated with obstetrical outcome.Patients and methods Inclusion criteria were: (1) thrombotic and/or obstetrical APS (Sydney criteria); (2) absence of conventional antiphospholipid antibodies (APL); (3) at least one persistent non-conventional APL among IgA anticardiolipin antibodies, IgA anti-B2GPI, anti-vimentin G/M, anti-annexin V G/M, anti-phosphatidylethanolamine G/M and anti-phosphatidylserine/prothrombin G/M antibodies. The exclusion criteria were: (1) systemic lupus erythematosus ( SLE) or SLE-like disease; and (2) other connective tissue disease.Results A total of 187 women (mean 33±5 years) with seronegative APS were included from 14 centres in Austria, Spain, Italy, Slovenia and France and compared with 285 patients with seropositive APS. Seronegative APS has more obstetrical rather than thrombotic phenotypes, with only 6% of venous thrombosis in comparison to seropositive APS. Cumulative incidence of adverse obstetrical events was similar in seronegative and seropositive APS patients, although higher rates of intrauterine deaths (15% vs 5%; p=0.03), of preeclampsia (7% vs 16%, p=0.048) and lower live birth term (36±3 vs 38±3 weeks of gestation; p=0.04) were noted in seropositive APS. The cumulative incidence of adverse obstetrical events was significantly improved in treated versus untreated seronegative APS (log rank<0.05), whereas there was no difference between patients who received aspirin or aspirin-low-molecular weighted heparin combination.Conclusion Several non-criteria APL can be detected in patients with clinical APS features without any conventional APL, with various rates. The detection of non-criteria APL and thus the diagnosis of seronegative APS could discuss the therapeutic management similar to seropositive APS, but well-designed controlled studies are necessary.