Portal de Periódicos da CAPES

The effect of triple therapy on the mortality of catastrophic anti-phospholipid syndrome patients

2018; Oxford University Press; Volume: 57; Issue: 7 Linguagem: Inglês

10.1093/rheumatology/key082

1462-0332

Ignasi Rodríguez‐Pintó, Gerard Espinosa, Doruk Erkan, Yehuda Shoenfeld, Ricard Cervera, Ricard Cervera, Gerard Espinosa, Ignasi Rodríguez‐Pintó, Yehuda Shoenfeld, Doruk Erkan, J.C. Piette, Małyszko Jacek, B Roca, Maria G. Tektonidou, Haralampos Μ. Moutsopoulos, J.J. Boffa, Joab Chapman, L Stojanovich, Marta Veloso, Sonja Praprotnik, Benjamin-Leon Traub, Ross M. Levy, Tan Daryl, Tan Daryl, MC Boffa, A.D. Makatsaria, Esperanza Cañas‐Ruano, Alberto Allievi, W You, M Khamastha, Simon Hughes, J Menendez Suso, Jorge H. Limón-Pacheco, M F Boriotti, Catarina Dias, GhanShyam Pangtey, S Miller, Seema M. Policepatil, L Larissa, S Marjatta, Schanen Carolyn, T Noortje, Katinka Reiner, S. Y. Yañez Arteaga, T Leilani, D. Langsford, Maciej Niedźwiecki, V. Queyrel, Ruxandra Moroti, Cristina Romero, Katarina Jeremić, Ana Paula Signori Urbano, Roberto Hurtado García, Ananya Das, N. Costedoat‐Chalumeau, F Yngvar, José A. Gómez‐Puerta, E de Meigs, J P Smith, Елена Хакимовна Захарова, Ali Nayer, Walton Douglas, R Lyndsey, Vanessa Blanco, Carmen Herrero Vicent, Korablina Natalya, Laura Damian, Erica Valentini, B Giula, Marta Casal Moura, O. Araujo Loperena, Y Ritter Susan, G. Guettrot Imbert, Hanan Almasri, Toni Hospach, Bouraoui Mouna, Alma Robles, Holly Wilson, Pablo Guisado, R Rocío García Ruiz, J Rodríguez,

Renal Diseases and Glomerulopathies

The objective of this study was to assess the effect that triple therapy (anticoagulation plus CS plus plasma exchange and/or IVIGs) has on the mortality risk of patients with catastrophic APS (CAPS) included in the CAPS Registry.Patients from the CAPS Registry were grouped based on their treatments: triple therapy; drugs included in the triple therapy but in different combinations; and none of the treatments included in the triple therapy. The primary endpoint was all-cause mortality. Multivariate logistic regression models were used to compare mortality risk between groups.The CAPS Registry cohort included 525 episodes of CAPS accounting for 502 patients. After excluding 54 episodes (10.3%), a total of 471 patients with CAPS were included [mean (s.d.) age 38.5 years (17); 68.2% female; primary APS patients 62%]. Overall, 174 (36.9%) patients died. Triple therapy was prescribed in 189 episodes (40.1%), other combinations in 270 (57.3%) and none of those treatments in 12 episodes (2.5%); the mortality rate in the three groups was 28.6, 41.1 and 75%, respectively. Triple therapy was positively associated with a higher chance of survival when compared with non-treatment [adjusted odds ratio (OR) = 9.7, 95% CI: 2.3, 40.6] or treatment with other combinations of drugs included in the triple therapy (adjusted OR = 1.7, 95% CI: 1.2, 2.6). No statistical differences were found between patients that received triple therapy with plasma exchange or IVIGs (P = 0.92).Triple therapy is independently associated with a higher survival rate among patients with CAPS.