Background Increasing interest has focussed upon assays which are not currently included in the Antiphospholipid syndrome (APS) classification criteria to detect antibodies directed against other phospholipids (PL), PL binding proteins and/or coagulation factors.
Objectives We carried out a systematic review to establish the prevalence of each non-criteria assay in APS and control populations.
Methods We searched PubMed and EMBASE using the keywords APS, antiphospholipid antibodies (aPL), non criteria, new assays, aCL, LA, anti-Domain I (aDI), anti-β2GPI, antiphosphatidylserine (aPS), antiphosphatidylethanolamine (aPE), antiphosphatidic acid (aPA), antiprothrombin (aPT), antiphosphatidylserine-prothtombin (aPS-PT), anti-cardiolipin/vimentin (CL/Vm) and Annexin A5 resistance (AnxA5R). Each publication was systematically examined.
Results We selected 14 (4 retrospective, 2 case-control and 8 cross-sectional) studies from which we were able to extract original data on prevalence of non-criteria aPL in 1307 patients with APS and 1612 disease controls and 625 healthy controls.
Conclusions The highest prevalence of non-criteria aPL in the largest number of patients with APS was found in studies of IgA anti β2GPI (56.33% in 229 APS patients), AnxA5R (53.37% in 163 APS patients) and IgG aDI (44% in 548 APS patients). All non-criteria aPL studied were found to be significantly raised in APS compared with controls. Most studies however, were confounded by: small sample size, retrospective collection; and different determination of positivity. Therefore, further prospective studies are urgently required to confirm these findings.
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Disclosure of Interest V. Rodríguez-García Grant/research support: FER grant from The Spanish Society of Rheumatology, Y. Ioannou: None declared, A. Fernández-Nebro: None declared, D. A. Isenberg: None declared, I. Giles: None declared