The Impact of Systemic Lupus Erythematosus on the Clinical Phenotype of Antiphospholipid Antibody–Positive Patients: Results From the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Clinical Database and Repository
Bibliographic record
Abstract
Objective Although systemic lupus erythematosus ( SLE ) is the most common autoimmune disease associated with antiphospholipid antibodies ( aPL ), limited data exist regarding the impact of SLE on the clinical phenotype of aPL ‐positive patients. The primary objective of this study was to compare the clinical, laboratory, and treatment characteristics of aPL ‐positive patients with SLE with those of aPL ‐positive patients without SLE. Methods A secure web‐based data capture system was used to store patient demographic characteristics and aPL ‐related clinical and laboratory characteristics. Inclusion criteria included positive aPL according to the updated Sapporo classification criteria. Antiphospholipid antibody–positive patients fulfilling the American College of Rheumatology criteria for the classification of SLE (“ aPL with SLE ”) and those with no other autoimmune diseases (“ aPL only”) were included in the analysis. Results Six hundred seventy‐two aPL ‐positive patients were recruited from 24 international centers; 426 of these patients did not have other autoimmune disease, and 197 had SLE . The frequency of thrombocytopenia, hemolytic anemia, low complement levels, and IgA anti–β 2 ‐glycoprotein I (anti‐β 2 GPI ) antibodies was higher in the aPL ‐positive patients with SLE , whereas the frequency of cognitive dysfunction and IgG anti‐β 2 GPI antibodies was higher in the aPL ‐only group. The frequency of arterial and venous thromboses (including recurrent) as well as pregnancy morbidity was similar in the 2 groups. The prevalence of cardiovascular disease risk factors at the time of entry into the registry entry did not differ between the 2 groups, with the exception of current smoking, which was more frequent in aPL ‐positive patients with SLE. Conclusion Although the frequencies of thrombosis and pregnancy morbidity are similar in aPL ‐positive patients with and those without SLE , the diagnosis of SLE in patients with persistently positive aPL is associated with an increased frequency of thrombocytopenia, hemolytic anemia, low complement levels, and positive IgA anti‐β 2 GPI antibodies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.040 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.005 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".