Antiphospholipid Antibodies Vary by Race in People With SLE

TOPLINE:

The prevalence of clinically meaningful levels of antiphospholipid antibodies (aPLs) is significantly lower among Black patients with systemic lupus erythematosus (SLE), compared with people of other races and ethnicities.

METHODOLOGY:

• The researchers reviewed data from seven longitudinal SLE cohorts including more than 2500 individuals to examine the overall prevalence of aPLs as well as their presence by race.

• Clinically meaningful aPLs were defined as the presence of lupus anticoagulant (LAC) and/or moderate-to-high titers of anticardiolipin (aCL) IgG/IgM and/or moderate-to-high titers of anti-β2 glycoprotein I antibody (aβ2GPI) IgG/IgM (at least 40 IgG phospholipid/IgM phospholipid units).

TAKEAWAY:

• The frequency of moderate-to-high aPLs in patients with SLE across multiple cohorts ranged from 3% to 7%.

• Compared with Asian, Hispanic, and white patients, the overall totals of clinically meaningful aCL IgG, aCL IgM, aβ2GPI IgG, and aβ2GPI IgM were significantly lower among Black patients (P < .0001, P = .01, P = .0002, P = .01, respectively).

• Trends were consistent across the seven cohorts.

• More research is needed to better understand the genetic and environmental factors contributing to this variability, and the results may inform clinical trials and patient management.

IN PRACTICE:

“Trials with new agents for SLE and [antiphospholipid syndrome] must enroll patients that reflect real-world racial and ethnic distribution of disease to assess potential differential treatment responses and assure equity in access,” the researchers write.

SOURCE:

The lead author on the study was Cécile M. Yelnik, MD, of the University of Lille in Lille, France. The study was published online October 24 in the Annals of the Rheumatic Diseases.

LIMITATIONS:

The study lacked multiple positive tests for classification criteria, which may have prompted overreporting of aPL positivity and clinical correlates for aPLs; use of local vs core labs also may have affected the results.

DISCLOSURES:

The study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, the Centers for Disease Control and Prevention, and an unrestricted grant from UCB. Several coauthors disclosed financial relationships with companies, including Pfizer, Sanofi, AstraZeneca, Gilead, and Horizon, that are unrelated to the current study.

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