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Effect of HCQ on AnxA5 Resistance Assay in Antiphospholipid (aPL) Positive Patients With and Without Systemic Lupus Erythematosus (SLE)

Completed
Conditions
Antiphospholipid Syndrome
Thrombophilia Due to Antiphospholipid Antibody
Systemic Lupus Erythematosus
Interventions
Other: Phlebotomy
Registration Number
NCT01475149
Lead Sponsor
Hospital for Special Surgery, New York
Brief Summary

This 12 week study will observe patients with and without systemic lupus erythematosus who have persistent antiphospholipid antibodies in the blood who are starting a medicine called hydroxychloroquine. It will measure if these patients have a change in a blood test called the annexin A5 resistance assay over that 12 week period.

Detailed Description

Antiphospholipid Syndrome (APS) is an autoimmune disorder of blood clotting and pregnancy loss. It is associated with proteins called antiphospholipid antibodies (aPL) in the blood. Blood clotting in this disease occurs for several reasons; one reason involves the interaction of aPL with another protein found on the surface of the cells that line blood vessels (endothelial cells). This protein, called annexin A5 (AnxA5), forms a shield over the surface of these cells. The AnxA5 Resistance Assay is a blood test that can detect when there is a problem with the protective AnxA5 shield on endothelial cell surfaces.

This 12 week study will observe patients with persistent aPL in the blood who are starting a medicine called hydroxychloroquine (HCQ). The primary goal of the study is to compare results of the AnxA5 resistance assay from patients before they start taking HCQ and after they have taken it for 12 weeks to see if the results of the blood test change. Our secondary goal is to measure a variety of other blood tests before and after patients have started taking HCQ; these tests include D-dimer, Activated Protein C (APC) Resistance, and aPL titers/status (LA test, aCL ELISA, aß2GPI ELISA, and anti-Domain-I ß2GPI ELISA).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
33
Inclusion Criteria
  • age 18 to 65
  • new HCQ (200-400 mg/day) treatment (for all but 5 of 10 control subjects - see below)
  • persistently positive aPL

Selected

Exclusion Criteria
  • Steroid use greater than or equal to the equivalent of prednisone 0.5 mg/kg/day at the time of enrollment
  • Heparin use at the time of enrollment
  • Any immunosuppressive drug use within 3 months prior to screening
  • HCQ use within the past 6 months prior to screening visit
  • Another antimalarial agent treatment,
  • Pregnant women, minors, mentally disabled, prisoners
  • Acute thrombosis within 2 weeks prior to screening

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
aPL positive - group 1PhlebotomyaPL positive with APS, receiving HCQ
aPL positive - group 2PhlebotomyaPL positive with APS and SLE, receiving HCQ
aPL negative - group 2PhlebotomyaPL negative with SLE, not receiving HCQ
aPL positive - group 3PhlebotomyaPL positive without APS but with SLE, receiving HCQ
aPL positive - group 4PhlebotomyaPL positive without APS or SLE, receiving HCQ
aPL negative - group 1PhlebotomyaPL negative with SLE, receiving HCQ
Primary Outcome Measures
NameTimeMethod
Change in Annexin A5 resistance assay12 weeks

The primary goal of the study is to compare results of the AnxA5 resistance assay from patients before they start taking HCQ and after they have taken it for 12 weeks to see if the results of the blood test change.

Secondary Outcome Measures
NameTimeMethod
Change in D-dimerBaseline and 12 weeks
Change in anticardiolipin (aCL) ELISABaseline and 12 weeks
Change in anti-B2-glycoprotein-I (aB2GPI) ELISABaseline and 12 weeks
Change in anti-Domain-I B2GPI ELISABaseline and 12 weeks
Change in activated protein C (APC) resistance coagulation assayBaseline and 12 weeks
Change in LA functional coagulation assayBaseline and 12 weeks

Trial Locations

Locations (1)

Hospital for Special Surgery

🇺🇸

New York City, New York, United States

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