User:Mhowiki/Antiphospholipid syndrome/Bibliography

You will be compiling your bibliography and creating an outline of the changes you will make in this sandbox.

Treatment

 * Zuily, Stephane et al. Use of DOACs....Guidance from the Scientific and Standardization Committee of the International Society on Thrombosis and haemostasis
 * this is article was added to the talk page but is not as recent as the other studies I included


 * Khairini, Candrika et al. DOACs vs Vit K in Patients with Antiphospholipid Syndrome
 * Reliability: systemic review and meta-analysis of RTCs from peer reviewed journal,
 * Strengths: used typical meta-analysis analysis recommendations, little to no heterogeneity, good inclusion/exclusion criteria, put extra effort to look for missing information or look for all availalbe articles
 * Limitations: only used 4 RTCs (used two of the same trials- RAPS and TRAPS- as citation 3), wide confidence intervals, subgroup analysis not randomized but instead organized post hoc by article investigators,
 * This study had subgroup analysis (triple positive vs other), looked at more outcomes (stroke, MI, and PE), and had nonmajor bleeding which the other did not
 * Showed increased risk of arterial events and strokes when on DOACs vs Vit K anatogonists BUT NOT venous events, DVT, PE, major and nonmajor bleeding. The arterial events was high on the grade criteria (which apparently is used to develop clinical reccommednations internationally).
 * 3/4 cohort was triple positive and 1/4 was other. no difference between subgroups
 * "Direct oral anticoagulants in antiphospholipid syndrome: Meta-analysis of randomized controlled trials"
 * Reliability: systemic review and meta-analysis of RTCs from peer reviewed journal
 * Limitations: only used 4 RTCs, 3/4 were rivaroxaban vs warfarin, triple positivity APS antibodies not consistent across 4 studies, one of the studies didn't folow sapporo or sydney criteria (not two positive APS antibody tests), pretty wide confidence interval for significant increase in arterial events vs venous events in patients on DOACs vs Vit K antagonists, significant heterogeneity in bleeding events on DOACS vs Vit K anagonists, did not include nonmajor bleeding as outcome because of inconsistent definition in trials
 * Strengths: little to no heterogeneity in comparing studies for all events or venous/arterial events
 * Results: significant increase in arterial events in patients on DOACs vs Vit K antagonists. No significant change in all events or venous events between groups. No significant major bleeding events in either group.
 * Cites the European Cardiology society recommending not using DOACs in any APS patients(S.V. Konstantinides, G. Meyer, C. Becattini, H. Bueno, G.-J. Geersing, V.-P. Harjola, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) Eur Heart J, 41 (2020), pp. 543-603)
 * "Comparing the efficacy and safety of direct oral anticoagulants versus Vitamin K antagonists in patients with antiphospholipid syndrome: a systematic review and meta-analysis"
 * meta-analysis, subgroup analysis with triple positive first 1/2 positivity
 * results showed that there was no difference between DOAC and vit K groups in future blood clots but still saw increased risk of blood clots in triple positive and those with past arterial thrombosis
 * "Management of thrombotic and obstetric antiphospholipid syndrome: a systematic literature review informing the EULAR recommendations for the management of antiphospholipid syndrome in adults"
 * systemic review with some pooled results
 * used to support/form EULAR recommendations below
 * some of the data discussed is not based on pooled results but more of a narrative evidence based review of aritcle results. I used only recommendations that were informed by meta-analysis they used in this study (highest rated evidence). The limitations to a lot of these studies, especially obstetric APS, is inconsistent groups, criteria, and incorporation of placebo/inferior treatment arms
 * EULAR recommendations for management of APS
 * low dose aspirin recommended for asymptomatic individuals with APS antibodies, high risk people with SLE and APS antibodies but no clinical signs, non-pregnant people who had APS during pregnancy (supported by metanalysis- highest recommendation)
 * warfarin (vit K antagonists) is recommended for maintenance therapy after first venous or arterial thrombosis
 * low dose aspirin and heparin is recommended for pregnant individuals with only obstetric symptoms of APS (not thrombotic symptoms) and pregnant individuals with past blood clots from APS
 * these are recommendations from an international body that did a thorough review of the literature with strict inclusion/exclusion criteria. Each article was graded by a rubric by multiple investigators and data extracted by at least two, which may limit bias. These were then used (along with expert opinion) to grade and create recommendations. I have only discussed above the highest recommendations based off of meta-analyses or multiple studies they pooled. They also acknowledge lack of standardization in cohorts studied (symptoms differ and are not standard).
 * "Effect of Hydroxychloroquine on Lupus Activity, Preeclampsia and Intrauterine Growth Restriction in Pregnant Women with Systemic Lupus Erythematosus and/or Antiphospholipid Syndrome: A Systematic Review and Meta-Analysis"
 * meta-analysis
 * may speak to treatment
 * hydroxychoroquine helped lupus patients but not patients with APS
 * will not add

Diagnostic Testing/Research Criteria

 * https://pubmed.ncbi.nlm.nih.gov/16420554/ article linke for Sydney criteria, needs to be added to article, could not find article on Sapporro criteria


 * 2023 ACR/EULAR Criteria for observational and trial studies
 * national guidelines for research purposes
 * interestingly something mentioned in here is that these are meant for research purposes (need to identify individuals they are VERY certain have the disease) and not all individuals with antiphospholipid syndrome will fulfill criteria, emphasizing the importance of rheumatologist judgment in clinical diagnosis. This is not reflected in the Wiki article. I think this nuance could be introduced.
 * comparing 2023 vs 2006 guidelines, 2023 guidelines had higher specificity (significant with no overlap in confidence intervals) but lower sensitivity (confidence intervals didn't overlap between both guidelines making it not significant difference).
 * major changes were that they added heart manifestations and thrombocytopenia as clinical criteria and changed some thresholds and specifics about the antibody tests
 * limitations
 * meta-analyses they used to narrow criteria included 4 where all participants concomitantly had lupus
 * does not do met-analysis or systematic review; was mostly based of off many groups of expert opinion (whether doctors or researchers) and their knowledge/clinical reasoning/cases
 * used 6 categories for clinical symptoms: macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic
 * Devreese KM, de Groot PG, de Laat B, et al. Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis: update of the guidelines for lupus anticoagulant detection and interpretation. J Thromb Haemost 2020; 18: 2828–39.
 * international guideline update
 * discuss situations in which you should measure APS antibodies and situations in which you should cautiously interpret results
 * be careful during pregnancy, during/right after thrombosis, situations where theres high acute phase reactants of lipids/bilirubin, and if patient is taking an anticoagulant (warfarin, DOAC, heparin....)
 * best to retest 3 months postpartum to determine if test during pregnancy was false positive/negative
 * test if young with signs and symptoms or unprovoked VTE or uncharacteristically placed VTE and always in SLE
 * Thrombophilia testing
 * systematic review from peer reviewed journal
 * discusses testing they could be done and times in which it would be good to test a person
 * Devreese, K. M. J.; Ortel, T. L.; Pengo, V.; de Laat, B.; Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies (2018-04). "Laboratory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH". Journal of thrombosis and haemostasis: JTH. 16 (4): 809–813.
 * guidelines from international committee
 * summarizing changes since 2006 Syndey criteria but prior to 2020 article above
 * https://pubmed.ncbi.nlm.nih.gov/32185783/ thoughts on less commonly tested antibody

Prognosis

 * "Pregnancy outcome predictors in antiphospholipid syndrome: A systematic review and meta-analysis"
 * systemic review and meta-analysis
 * results: ended up with 27 studies in meta-analysis. For some variables not many studies looked at that outcome (like some only had 2-3 studies), this left small n for some predictor and outcome sets. This was often seen in variables that ended up not being significant predictors. The variables that were significant predictors ended up having n>1000 most of the time and more studies looking at this. This may be a limitation for the results that are not significant becausue would they be significant with more subjects.
 * Previous thrombosis and 2-3 + antibodies led to decreased risk of live birth. Previous thrombosis also led to increased risk of SGA, neonatal mortality, and antenatal/postnatal thrombosis. Triple positivity and presence of lupus anticoagulant increased risk of preeclampsia and SGA. The presence of autoimmune disease did not have a significant OR ratio
 * Bias: they mention ambiguous recruitment in the studies, inconsistent outcome definitions, could not do pooled subgroup analysis,
 * Strengths: Did not report studies with heterogeneity >75%, used stringent method of narrowing articles and evaluating, had third party come in when disagreements between articles
 * "Risk of Subclinical Atherosclerosis in Patients with Antiphospholipid Syndrome and Subjects With Antiphospholipid Antibody Positivity: A Systematic Review and Meta-analysis"
 * meta-analyasis using PRISMA and cochrane guidelines, looked at a lot of sources including google search
 * results suggest that APS increases atherosclerotic disease
 * population may be heterogenous and have differing CVD risk factors and demographic characteristics

Symptoms

 * Sciascia S, Radin M, Cecchi I, et al. 16th International congress on antiphospholipid antibodies task force report on clinical manifestations of antiphospholipid syndrome. Lupus 2021; 30: 1314–26.
 * international task force guidelines using the GRADE system, they convene every 3 years
 * only included systematic reviews and meta-analyses in their lit review
 * "heterogenous" presentations, no single agreed upon guidelines exists for diagnostic purposes
 * GRADES for whether or not it is indicative enough of APS
 * thromboembolic pulmonary hyperternsion: moderate
 * recurrent cardiac events: moderate
 * "Non-Ischemic neurological involvement of the central nervous system (migraine, epilepsy, psychosis and other psychiatric symptoms)": very low
 * thrombocytopenia: moderate
 * Risk stratification
 * Accepted prognostic factors
 * triple positive antibodies associated with more blood clots
 * moderate to high titer levels vs low levels and IgG vs IgM are better at predicting events
 * aPL Score (aPL-S) and the Global APS score (GAPSS): both assign certain amount of points to different antibody levels to stratify risk level
 * Otomo K, Atsumi T, Amengual O, et al. Efficacy of the antiphospholipid score for the diagnosis of antiphospholipid syndrome and its predictive value for thrombotic events. Arthritis Rheum 2012; 64: 504–512. 28.
 * Sciascia S, Sanna G, Murru V, Roccatello D, Khamashta MA and Bertolaccini ML. GAPSS: the Global AntiPhospholipid Syndrome Score. Rheumatology (Oxford) 2013; 52: 1397–1403.
 * Cheng, Chunyan; Cheng, Gang-Yi; Denas, Gentian; Pengo, Vittorio (2021-07-01). "Arterial thrombosis in antiphospholipid syndrome (APS): Clinical approach and treatment. A systematic review". Blood Reviews. 48: 100788.
 * systematic review from peer reviewed journal using PRISMA
 * stroke was most common manifestation of arterial thrombosis


 * Domingues V, Chock YP, Risse J, et al. Increased risk of acute and chronic renal lesions associated with antiphospholipid antibodies in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Autoimmun Rev 2022; 21:103158.
 * found citation in 2023 ACR/EULAR Criteria article where they used to help narrow criterion from reseachers


 * Loiseau P, Foret T, DeFilippis EM, et al. Risk of livedo reticularis with antiphospholipid antibodies in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Lupus 2022; 31: 1595–605.
 * found citation in 2023 ACR/EULAR Criteria article where they used to help narrow criterion from reseachers


 * "Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review"
 * systemic-analysis
 * From predatory journal, will not use in article
 * Hemolytic anemia in APS and lupus
 * https://pubmed.ncbi.nlm.nih.gov/33420626/
 * article on autoimmune diseases associated with APS

Mechanisms

 * "Prevalence of aPhosphatidylserine/prothrombin antibodies and association with antiphospholipid antibody profiles in patients with antiphospholipid syndrome: A systematic review and meta-analysis"
 * systematic review and meta-analysis
 * "Dendritic Cells and Antiphospholipid Syndrome: An Updated Systematic Review"

Outline of proposed changes
I plan on adding citations to the 17 facts that need citing.

Sources needed for


 * 1) primary vs secondary classications (patho)