Non-criteria antiphospholipid antibody profiles and thrombotic outcomes in a cohort of patients with systemic lupus erythematosus
Bibliographic record
Abstract
OBJECTIVES: Antiphospholipid syndrome (APS) is characterised by the presence of antiphospholipid antibodies (aPLs) and clinical outcomes of thrombosis and/or obstetric morbidity and is associated with systemic lupus erythematosus (SLE). IgG antiphosphatidylserine/prothrombin complex (aPS/PT), IgM aPS/PT and IgG anti-beta 2 glycoprotein 1-domain 1 (aβ2GP1-D1) are novel aPLs that have been associated with thrombosis; however, conclusive data are still lacking. It remains unclear how best to incorporate non-criteria autoantibodies into clinical decision-making. The aim of this study was to assess whether these novel aPLs were associated with an increased risk of thrombosis in patients with SLE. METHODS: We evaluated 341 patients enrolled in the SouThern Alberta Registry for Lupus EryThematosus database with SLE by the American College of Rheumatology or Systemic Lupus International Collaborating Clinics classification criteria. Medical records were reviewed between March 2006 and January 2021 for thrombotic events and serology results for lupus anticoagulant, IgG anticardiolipin, IgG anti-beta 2 glycoprotein 1 (aβ2GP1), IgG aPS/PT, IgM aPS/PT and IgG aβ2GP1-D1. RESULTS: Among 341 patients with SLE, 59 (17%) met the revised Sapporo lab criteria, and of those 29 (49%) had a major thrombotic event (OR 3.5, 95% CI 1.9 to 6.3). Among 142 patients who had at least one positive non-criteria autoantibody, 45 (32%) had a major thrombotic event (OR 1.6, 95% CI 0.97 to 2.6). In a univariate analysis, the IgG aPS/PT and IgG aβ2GP1-D1 were associated with major and all thrombotic events. In a multivariate analysis that controlled for age, sex, prednisone use, SLE disease activity (Systemic Lupus Erythematosus Disease Activity Index-2K and the revised Sapporo lab criteria, among the non-criteria aPLs, only IgG aPS/PT was associated with an increased risk of a major thrombosis (OR 2.2, 95% CI 1.1 to 4.5). CONCLUSIONS: In our multivariate analysis, IgG aPS/PT was associated with a modestly increased risk of thrombotic events.
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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 | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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; a candidate call from one teacher head, not a consensus.
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".