Descriptive analysis of patients positive for anti-phospholipid antibodies included in two Italian registries

The definite diagnosis of antiphospholipid syndrome (APS) depends on the laboratory performance and clinicians’ interpretation. Results from two Italian inception cohort studies of anti-phospholipid antibodies (aPL)-positive subjects, the Italian Survey on ANtiphoSpholipid antibody Positive Individuals Registry (INSPIRE) and the Survey on AnTicoagulated Patients-RegisTry (START) have been compared. Data from INSPIRE were collected by rheumatologists of the FIRMA group while those of START by physicians working in Italian thrombosis centers. Evidence on several, still unraveled, clinical and methodological aspects of ‘real life’ aPL testing and APS diagnosis was collected. In this paper, we report the characteristics of 123 cases enrolled in INSPIRE and 229 in START registries, with particular reference to the reasons why these tests were requested, the obtained aPL profile, and consequent treatment. Laboratory testing for aPL in the absence of clinical criteria defining APS was more frequent in INSPIRE (p<0.0001). The rate of patients in classification category I (more than one aPL test positive) was significantly higher in START (p<0.0001) as well as the use of warfarin. A wide variety of treatments has been observed in patients in classification category II (single aPL positivity). These data indicate that there is a need to harmonize many aspects among the various specialists dealing with APS.