Global Antiphospholipid Syndrome Score (GAPSS) in Patients with Systemic Lupus Erythematosus

F A Cheldieva; T M Reshetnyak; A A Shumilova; K S Nurbaeva; M V Cherkasova; A M Lila; E L Nasonov

doi:10.1134/S160767292370028X

Global Antiphospholipid Syndrome Score (GAPSS) in Patients with Systemic Lupus Erythematosus

Dokl Biochem Biophys. 2023 Aug;511(1):227-234. doi: 10.1134/S160767292370028X. Epub 2023 Oct 13.

Authors

F A Cheldieva¹, T M Reshetnyak², A A Shumilova², K S Nurbaeva², M V Cherkasova², A M Lila^{2

3}, E L Nasonov^{2

4}

Affiliations

¹ Laboratory of Thromboinflammation, Nasonova Research Institute of Rheumatology, Moscow, Russia. fariza_cheldieva@mail.ru.
² Laboratory of Thromboinflammation, Nasonova Research Institute of Rheumatology, Moscow, Russia.
³ Department of Rheumatology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia.
⁴ Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

Abstract

The Global Antiphospholipid Syndrome Score (GAPSS) is a tool proposed to quantify the risk of clinical manifestations associated with antiphospholipid antibodies (aPL) and certain cardiovascular risk factors. To validate GAPSS in a cohort of patients with systemic lupus erythematosus in Russia. 115 patients with SLE were included in the study, including 51 (44%) patients with systemic lupus erythematosus (SLE) with antiphospholipid syndrome (APS), 14 (12%) SLE patients with aPL, and 50 (44%) patients with SLE. There was a history of thrombosis in 58 (50%) out of 115 patients; of them, 14 (24%) had arterial thrombosis, 29 (50%) had venous thrombosis, and 15 (26%) had combined thrombosis. Pregnancy against the background of the disease occurred in 43 women included in the study. Of them, 29 (67%) had obstetric pathology. Patients with thrombosis and obstetric pathology had a GAPSS score of 7.17 ± 5.64 versus 4.48 ± 4.55 without these manifestations (p = 0.0003). There was a significant association between GAPSS levels and thrombosis: patients with thrombosis had a GAPSS of 7.31 ± 5.70, those without thrombosis-4.00 ± 4.81 (p = 0.001). GAPPS values were higher in arterial thrombosis compared to venous thrombosis (10.40 ± 25.30 versus 5.82 ± 5.28, p = 0.01). GAPSS levels ≥ 6 and ≥10 were analyzed to select GAPSS values at which a high risk of recurrent thrombosis and/or obstetric pathology could be indicated. All GAPSS levels had a significant association with clinical manifestations of APS. The quality of GAPSS by ROC analysis showed an area under the curve (AUC) for GAPSS of 0.697. GAPSS can be used to assess the risk of recurrence or development of thrombosis and/or obstetric pathology in patients with SLE in the Russian Federation. The GAPSS ≥6 values should be used to stratify patients with SLE into high risk group for recurrence of vascular complications. Further prospective follow-up is needed to confirm the value of GAPSS.

Keywords: antiphospholipid antibodies; antiphospholipid syndrome; disease activity; obstetric pathology; systemic lupus erythematosus; thrombosis.

MeSH terms

Antibodies, Antiphospholipid
Antiphospholipid Syndrome* / complications
Antiphospholipid Syndrome* / diagnosis
Female
Humans
Lupus Erythematosus, Systemic* / complications
Lupus Erythematosus, Systemic* / diagnosis
Pregnancy
Thrombosis* / complications
Venous Thrombosis* / diagnosis
Venous Thrombosis* / epidemiology
Venous Thrombosis* / etiology

Substances

Antibodies, Antiphospholipid