Chengappa Kavadichanda: How Do aPLs Change Over Time in Early Lupus?
Chengappa Kavadichanda, Senior Consultant, Country Lead – Allergy and Immunology at RheumaCARE, Assistant Editor at Indian Journal of Rheumatology, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Rheumatology, adding:
“I was lucky to be caring for the lupus patients of the INSPIRE inception cohort at JIPMER, following them from diagnosis and, with our team, collecting and storing their serum and clinical data at every visit.
Seeing those samples turn into answers is deeply rewarding, and I’m happy to share our new paper in Rheumatology (BSR or OUP):
‘Antiphospholipid antibody trajectories and clinical correlates in an inception cohort of systemic lupus erythematosus.’
With paired samples at baseline, 6 and 24 months from 270 patients, we could ask a question a single test cannot answer: how do aPLs behave over time in early lupus?
What we found:
- 77% were aPL-positive at least once, mostly at low titres that fluctuated a lot
- Moderate-high titre aPLs were less common and far more stable
- Negativization tracked baseline burden: 31.5% with single positivity, 8.1% with dual, 0% with triple
- 3.1% moved from negative or low-titre to a high-risk profile
- 7% developed thrombosis over 2 years, with higher risk in high-risk (OR 7.6) and persistently positive (OR 5.2) profiles
- No thrombotic events in patients who stayed aPL-negative throughout
- aPL titres did not track SLEDAI-2K or PGA.
The message for the clinic: aPL status in early SLE is dynamic, and serial testing sharpens risk stratification.
This is what well-kept longitudinal cohorts give back.
Huge thanks to Dr Ritesh Kumar Mishra for leading the analysis; to Prof. Molly Thabah, Prof. Vir Singh Negi and Prof. Amita Aggarwal; to our lab and clinical staff; and most importantly to our patients and their families, for their trust and participation.”
Title: Antiphospholipid antibody trajectories and clinical correlates in an inception cohort of systemic lupus erythematosus
Authors: Ritesh Kumar Mishra, Chengappa Kavadichanda, Priyanka Baskaran, Subin Philip, Rizwana Naushad, Sriyanka Mohapatra, Mani Rajendran, Kalaichelvi Kalidass, Aishwarya Gopal, Christina Mary Mariaselvam, Molly Mary Thabah, Vir Singh Negi, Amita Aggarwal
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