title: The contribution of antiphospholipid antibodies to organ damage in systemic lupus erythematosus.
abstract: OBJECTIVE
  The objective of this study was to assess the contribution of clinically significant antiphospholipid antibodies (aPL) to organ damage in systemic lupus erythematosus (SLE).
  
  
  METHODS
  Patients with disease duration of less than 10 years and at least 5 years of follow-up were identified from two SLE registries. A clinically significant antiphospholipid antibody (aPL) profile was defined as: positive lupus anticoagulant, anticardiolipin IgG/M ≥ 40 G phospholipid units (GPL)/M phospholipid units (MPL), and/or anti-β2-glycoprotein-I IgG/M ≥ 99th percentile on two or more occasions, at least 12 weeks apart. Organ damage was assessed by the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Univariate and multivariate analysis compared SLE patients with and without SDI increase during a 15-year follow-up.
  
  
  RESULTS
  Among 262 SLE patients, 33% had a clinically significant aPL profile, which was associated with an increased risk of organ damage accrual during a 5-year follow-up in univariate analysis, and during a 15-year follow-up in the multivariate analysis adjusting for age, gender, race, disease duration at registry entry, and time. In the multivariate analysis, older age at diagnosis and male gender were also associated with SDI increase at each time point.
  
  
  CONCLUSIONS
  A clinically significant aPL profile is associated with an increased risk of organ damage accrual during a 15-year follow-up in SLE patients.
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy mara.taraborelli@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Taraborelli
authors.affiliation: Rheumatology, Hospital for Special Surgery, New York, United States.
authors.forename: L
authors.initials: L
authors.lastname: Leuenberger
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Lazzaroni
authors.affiliation: Rheumatology and Clinical Immunology, University of Brescia, Brescia, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Martinazzi
authors.affiliation: Healthcare Research Institute, Hospital for Special Surgery, New York, United States.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Franceschini
authors.affiliation: Rheumatology, Hospital for Special Surgery, New York, United States.
authors.forename: J
authors.initials: J
authors.lastname: Salmon
authors.affiliation: Rheumatology and Clinical Immunology, Spedali Civili and University of Brescia, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Tincani
authors.affiliation: Rheumatology, Hospital for Special Surgery, New York, United States.
authors.forename: D
authors.initials: D
authors.lastname: Erkan
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Systemic lupus erythematosus; antiphospholipid antibodies; organ damage