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Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry.

Publication ,  Journal Article
Zuily, S; Clerc-Urmès, I; Bauman, C; Andrade, D; Sciascia, S; Pengo, V; Tektonidou, MG; Ugarte, A; Gerosa, M; Michael Belmont, H; Zamorano, MAA ...
Published in: Lupus
October 2020

OBJECTIVE: This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients. METHODS: The Alliance for Clinical Trials and International Networking (APS ACTION) Registry includes persistently positive aPL of any isotype based on the Sydney antiphospholipid syndrome (APS) classification criteria. We performed CA on the baseline characteristics collected retrospectively at the time of the registry entry of the first 500 patients included in the registry. A total of 30 clinical data points were included in the primary CA to cover the broad spectrum of aPL-positive patients. RESULTS: A total of 497 patients from international centres were analysed, resulting in three main exclusive clusters: (a) female patients with no other autoimmune diseases but with venous thromboembolism (VTE) and triple-aPL positivity; (b) female patients with systemic lupus erythematosus, VTE, aPL nephropathy, thrombocytopaenia, haemolytic anaemia and a positive lupus anticoagulant test; and (c) older men with arterial thrombosis, heart valve disease, livedo, skin ulcers, neurological manifestations and cardiovascular disease (CVD) risk factors. CONCLUSIONS: Based on our hierarchical cluster analysis, we identified different clinical phenotypes of aPL-positive patients discriminated by aPL profile, lupus or CVD risk factors. Our results, while supporting the heterogeneity of aPL-positive patients, also provide a foundation to understand disease mechanisms, create new approaches for APS classification and ultimately develop new management approaches.

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Published In

Lupus

DOI

EISSN

1477-0962

Publication Date

October 2020

Volume

29

Issue

11

Start / End Page

1353 / 1363

Location

England

Related Subject Headings

  • Arthritis & Rheumatology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Zuily, S., Clerc-Urmès, I., Bauman, C., Andrade, D., Sciascia, S., Pengo, V., … APS ACTION Investigators, . (2020). Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry. Lupus, 29(11), 1353–1363. https://doi.org/10.1177/0961203320940776
Zuily, Stéphane, Isabelle Clerc-Urmès, Cédric Bauman, Danieli Andrade, Savino Sciascia, Vittorio Pengo, Maria G. Tektonidou, et al. “Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry.Lupus 29, no. 11 (October 2020): 1353–63. https://doi.org/10.1177/0961203320940776.
Zuily S, Clerc-Urmès I, Bauman C, Andrade D, Sciascia S, Pengo V, et al. Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry. Lupus. 2020 Oct;29(11):1353–63.
Zuily, Stéphane, et al. “Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry.Lupus, vol. 29, no. 11, Oct. 2020, pp. 1353–63. Pubmed, doi:10.1177/0961203320940776.
Zuily S, Clerc-Urmès I, Bauman C, Andrade D, Sciascia S, Pengo V, Tektonidou MG, Ugarte A, Gerosa M, Michael Belmont H, Zamorano MAA, Fortin P, Ji L, Efthymiou M, Cohen H, Branch DW, Jesus GRD, Nalli C, Petri M, Rodriguez E, Cervera R, Knight JS, Atsumi T, Willis R, Bertolaccini ML, Vega J, Wahl D, Erkan D, APS ACTION Investigators. Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry. Lupus. 2020 Oct;29(11):1353–1363.
Journal cover image

Published In

Lupus

DOI

EISSN

1477-0962

Publication Date

October 2020

Volume

29

Issue

11

Start / End Page

1353 / 1363

Location

England

Related Subject Headings

  • Arthritis & Rheumatology
  • 3202 Clinical sciences
  • 1103 Clinical Sciences