OUTCOME OF PATIENTS WITH NON-CRITERIA MANIFESTATIONS OF PRIMARY ANTIPHOSPHOLIPID SYNDROME TREATED WITH IMMUNOSUPPRESSANTS -A SINGLE-CENTER STUDY
Bibliographic record
Abstract
PV022 / #697 Poster Topic: AS03 - Antiphospholipid Syndrome Background/Purpose Background: The frequency of non-criteria manifestations in Primary antiphospholipid syndrome (PAPS) is 24%. The efficacy of immunosuppressants in patients with above condition is not certain due to paucity of evidence. Objectives: To evaluate the outcome of patients who have been treated with immunosuppressive drugs for treatment of non-criteria manifestations of PAPS. Methods Patients with the diagnosis of APS or probable APS, attending our clinics between 2010 to 2024 were screened. Among these, those satisfying the APL domain of ACR/EULAR 2023 criteria and had at least 1 non criteria manifestation not attributable to any other defined CTD or disease and have been treated with immunosuppressive therapy were included. The non-criteria manifestations included all the ones mentioned in ACR/EULAR criteria or autoimmune haemolytic anemia (AIHA) and catastrophic APS (CAPS). Data regarding clinical presentation, laboratory abnormality, treatment and response were included. The primary outcome was the clinical improvement or resolution of the presenting manifestation after initiation of therapy. The results are depicted descriptively. Results A total of 44 patients 28 females, mean age 38±13 (SD) years satisfied the inclusion criteria. The most common non-criteria manifestation was thrombocytopenia (24, 54 %) followed by AIHA (12,27%) (Table 1). Rituximab was the most common immunosuppressant used in 19(43%) followed by mycophenolate (18 (40%). 90% received antiplatelet and anticoagulants. During a median follow-up of 32 months (IQR: 20-63), 80% patients responded to treatment. The response was sustained in 59% at the last follow-up. The best response was noted among patients with thrombocytopenia. n=20(83%) of thrombocytopenia responded to immunosuppressive treatment including rituximab (n=9, 81%), mycophenolate (n=5,85%) and Azathioprine (n=6, 66%). Response rates of all manifestations is depicted in Table 2. Major adverse events included death in 2 patients due to sepsis and pneumocystis carinii pneumonia in patients receiving rituximab and 1 death due to sepsis, disseminated TB, Ca breast in patients receiving MMF. Table 1. Table 2: Comparison of response to therapy in patients receiving Rtx and mycophenolate/azathioprine Conclusions Among the patients with PAPS with non-criteria manifestation, the best response to immunosuppression was observed in those presenting with AIHA and thrombocytopenia. All manifestations except LAHPS and skin ulcers showed similar response with rituximab as well as mycophenolate/azathioprine.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".