Clinical and serological markers of antiphospholipid syndrome in Saudi Arabia: A multicenter retrospective study

Objectives: This study aimed to assess the clinical and laboratory features of patients with antiphospholipid syndrome (APS) in Saudi Arabia and to evaluate the impact of gender and APS type on clinical and immunological patterns. Methods: This retrospective multicenter study was conducted in Saudi Arabia between 2022 and 2024, reviewing the electronic medical records of patients diagnosed with APS based on the modified Sapporo criteria. Statistical analyses were used t-tests to compare age and gender, while Chi-square or Fisher’s exact tests were used to assess the clinical and laboratory features between primary APS (PAPS) and secondary APS (SAPS). Results: The study included 200 patients (50% males and 50% females). Of these, 76% had PAPS, and 24% had SAPS. The PAPS group had more men, and the SAPS group had more women. This difference was statistically significant. The mean age of the participants was 39 years, with males having a higher mean age than females. Males had higher thrombosis rates, while females showed more migraine and triple-positive antiphospholipid antibody (aPL) expression. The PAPS group had a higher likelihood of thrombosis and obstetric complications and was more frequently positive for lupus anticoagulant. The SAPS group had a higher mean age, propensity for migraines, seizures, thrombocytopenia, and triple-positive aPL expression. Conclusion: Despite the limitations of the retrospective design, and selection bias, this study showed that thrombosis risk and APS markers differed between males and females, and between PAPS and SAPS groups. This highlights the need for sex-specific and APS-type-specific management.