Do ethnoracial differences exist among antiphospholipid antibody-positive patients with no other systemic autoimmune diseases: results from the APS ACTION registry

The APS ACTION Registry was created to study long-term outcomes in persistently antiphospholipid antibody (aPL)-positive patients. The objectives of this study were to examine the ethnoracial differences in clinical and laboratory characteristics of aPL-positive patients with no other systemic autoimmune rheumatic diseases (SARDs). A web-based data capture system stores patient demographics and aPL-related medical history. Inclusion criteria are positive aPL results, based on the revised Sapporo APS classification criteria, tested at least twice within one year prior to enrollment. For this cross-sectional analysis of the baseline data, demographic, clinical, and laboratory characteristics of registry patients were analyzed based on self-reported ethnorace (White, Latin American Mestizo [LAM], Asian, and Black). 728 patients with no history of other SARD (78% with APS classification) were included in the analysis. The ethnoracial distribution was 516 (78%) White, 82 (12%) LAM, 49 (7%) Asian, and 13 (2%) Black. Based on ethnoracial comparisons: (a) there were less females among White patients; (b) livedo reticularis/racemosa was more frequent in LAM patients; and (c) triple aPL positivity was more frequent in Whites, while isolated lupus anticoagulant positivity was more common in LAM patients. In our international registry of persistently aPL-positive patients with or without APS classification, Blacks were the least frequently (2%) reported ethnoracial group. No major ethnoracial differences were found in the aPL-related clinical manifestations. Our analysis highlights the need for further investigation into the genetic and social determinants impacting the clinical and serologic phenotypes of aPL-positive patients across diverse populations.

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Journal
Advances in Rheumatology
Published
2026-04-16
DOI
https://doi.org/10.1186/s42358-026-00536-0
Primary Topic
Systemic Lupus Erythematosus Research
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article
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article

Do ethnoracial differences exist among antiphospholipid antibody-positive patients with no other systemic autoimmune diseases: results from the APS ACTION registry

Maria Efthymiou, Nina Kello, María Laura Bertolaccini, Ma Angeles Aguirre-Zamorano et al.
Advances in Rheumatology
Systemic Lupus Erythematosus Research
article

Do ethnoracial differences exist among antiphospholipid antibody-positive patients with no other systemic autoimmune diseases: results from the APS ACTION registry

Maria Efthymiou, Nina Kello, María Laura Bertolaccini, Ma Angeles Aguirre-Zamorano, D. Paredes, Leslie Skeith, Elena Gkrouzman, Bahar Artım-Esen, Flávio Signorelli, Ariadna Anunciación-Llunell, Giulia Pazzola, H. Michael Belmont, Rohan Willis, Maria G. Tektonidou, Jason S. Knight, Hannah Cohen, Ware Branch, Esther Rodríguez Almaraz, Carolina Bonilla Richero, Jose Pardos-Gea, Maria Gerosa, Massimo Radin, Michelle Petri, Zhuoli Zhang, Paul R. Fortin, Vittorio Pengo, Alí Duarte-García, Cecillia Nalli, Alicia Matijasevich, Denis Wahl, Tatsuya Atsumi, Danieli Castro Oliveira de Andrade, Savino Sciascia, Ann E. Clarke, Guillermo Pons-Estel, Doruk Erkan, Ricard Cervera, Megan R. W. Barber, Hui Shi
article en

Abstract

The APS ACTION Registry was created to study long-term outcomes in persistently antiphospholipid antibody (aPL)-positive patients. The objectives of this study were to examine the ethnoracial differences in clinical and laboratory characteristics of aPL-positive patients with no other systemic autoimmune rheumatic diseases (SARDs). A web-based data capture system stores patient demographics and aPL-related medical history. Inclusion criteria are positive aPL results, based on the revised Sapporo APS classification criteria, tested at least twice within one year prior to enrollment. For this cross-sectional analysis of the baseline data, demographic, clinical, and laboratory characteristics of registry patients were analyzed based on self-reported ethnorace (White, Latin American Mestizo [LAM], Asian, and Black). 728 patients with no history of other SARD (78% with APS classification) were included in the analysis. The ethnoracial distribution was 516 (78%) White, 82 (12%) LAM, 49 (7%) Asian, and 13 (2%) Black. Based on ethnoracial comparisons: (a) there were less females among White patients; (b) livedo reticularis/racemosa was more frequent in LAM patients; and (c) triple aPL positivity was more frequent in Whites, while isolated lupus anticoagulant positivity was more common in LAM patients. In our international registry of persistently aPL-positive patients with or without APS classification, Blacks were the least frequently (2%) reported ethnoracial group. No major ethnoracial differences were found in the aPL-related clinical manifestations. Our analysis highlights the need for further investigation into the genetic and social determinants impacting the clinical and serologic phenotypes of aPL-positive patients across diverse populations.

Advances in Rheumatology
Intermountain Healthcare (US), Hospital for Special Surgery (US), Northwell Health (US), University of Padua (IT), Johns Hopkins University (US), Inserm (FR), University of Massachusetts Chan Medical School (US), University of Calgary (CA), Universidade de São Paulo (BR), Shanghai Jiao Tong University (CN), King's College London (GB), University of Milan (IT), National and Kapodistrian University of Athens (GR), Peking University (CN), Cornell University (US), University of Utah (US), University of Michigan (US), Johns Hopkins Medicine (US), Ruijin Hospital (CN), Universidade do Estado do Rio de Janeiro (BR), NYU Langone Health (US), BioCruces Health research Institute (ES), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), Instituto Maimónides de Investigación Biomédica de Córdoba (ES), Hospital Universitario 12 De Octubre (ES), Hospital Provincial de Rosario (AR), Hospital Clínic de Barcelona (ES), Hospital Universitario Reina Sofía (ES), Mayo Clinic in Arizona (US), Vall d'Hebron Hospital Universitari (ES), Peking University First Hospital (CN), Hokkaido University Hospital (JP), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Université Laval (CA), Défaillance Cardiovasculaire Aiguë et Chronique, University College London (GB), University of Córdoba (ES), University of Turin (IT), The University of Texas Medical Branch at Galveston (US), Istanbul University (TR), University of Brescia (IT), Université de Lorraine (FR)
Good health and well-being
Openalex Percentile: Top 23%
Systemic Lupus Erythematosus Research
DOIOpen Access PDFOpenAlex
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