The following is a summary of “Adjusted Global Anti-Phospholipid Syndrome Score as predictor of damage accrual measured by Damage Index for APS: a longitudinal study,” published in the June 2023 issue of Rheumatology by Barilaro, et al.
For a study, researchers sought to analyze the association between the average ‘adjusted’ Global APS Score (aGAPSS) over time, as a surrogate of disease activity, and changes in the Damage Index for APS (DIAPS) during follow-up in patients with thrombotic and non-thrombotic APS.
A total of 200 APS patients were included in the study, comprising 138 with primary APS and 62 with APS associated with other autoimmune diseases. DIAPS change was calculated as the difference between baseline DIAPS and DIAPS at the end of the follow-up. The aGAPSS was calculated for each patient at baseline and yearly for up to 6 years (minimum 3 years). The average score per patient was computed as the reference aGAPSS. Linear regression models analyzed the association between mean aGAPSS and DIAPS change. Additionally, factors associated with high (increase of DIAPS ≥1 during follow-up) vs low (increase of DIAPS <1 during follow-up) damage accrual were assessed.
The study found that a higher mean aGAPSS value was associated with an increase in DIAPS during follow-up (b = 0.04, P < 0.001) in the multivariate analysis. Patients with a DIAPS increase ≥1 during follow-up had higher mean aGAPSS values compared to those with an increase of <1 point [9.22 (95% CI 7.58, 10.86) vs 6.72 (95% CI 6.0, 7.43), P = 0.003]. Moreover, aGAPSS increased the odds of a DIAPS increment of ≥1 point during follow-up [OR = 1.12 (95% CI 1.04, 1.21), P = 0.003].
The study supported the utility of longitudinally assessing the aGAPSS score in predicting damage accrual, as measured by DIAPS, in patients with APS. The finding can help understand disease activity and guide appropriate management strategies for APS patients.