{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:21:42Z","timestamp":1791235302090,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,6,18]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with antiphospholipid syndrome (APS) display a wide range of clinical manifestations with similar immunological profile with the presence of lupus anticoagulant in around 70% of them. Although antiphospholipid antibodies (aPL) profile influences the risk of thrombosis in APS, APS risk stratification remains to be improved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our study aimed to evaluate thrombin generation test (TGT) interest to improve disease severity stratification in APS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/methods<\/jats:title>\n                    <jats:p>In this monocentric, transversal study, we included unselected primary thrombotic APS patients, fulfilling APS classification criteria and treated by vitamin K antagonist (VKA). 28 non-APS patients under VKA followed in our hospital were included as controls. TGT was performed on plasma samples with the calibrated automated thrombogram in our core laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between January 2020 and March 2023, 114 thrombotic APS patients (without systemic lupus erythematosus) were included (female 71 (62.3%), mean age 50\u00b114 years old, median duration since the last APS event of 51 months (IQR 23\u2013129 months)). APS patients had prolonged lag time (LT) and time to peak (TTP) compared with anticoagulated controls. History of relapse, catastrophic APS (CAPS), all aPL positivities and elevated Bb fragments were strongly associated with a prolonged LT and TTP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that APS patients under VKA had significantly prolonged TGT times compared with anticoagulated controls, with the greatest prolongations in patients with history of relapse or CAPS. Thus, TGT might be a useful tool to improve APS disease severity stratification without temporary cessation of VKA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005489","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T22:50:26Z","timestamp":1751410226000},"page":"e005489","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Thrombin generation test as a useful tool for improving disease severity stratification in antiphospholipid syndrome"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4260-5035","authenticated-orcid":false,"given":"Cecile","family":"Yelnik","sequence":"first","affiliation":[{"name":"D\u00e9partement de M\u00e9decine Interne et d\u2019Immunologie Clinique, Centre de r\u00e9f\u00e9rence des Maladies Auto-Immunes et Auto-inflammatoires Syst\u00e9miques rares de l\u2019Adulte du Nord, Nord-Ouest, M\u00e9diterran\u00e9e et Guadeloupe (CeRAINOM), European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNECT), University Hospital of Lille, CHU Lille, Lille, France"},{"name":"RID-AGE - Facteurs de risque et d\u00e9terminants mol\u00e9culaires des maladies li\u00e9es au vieillissement, INSERM U1167, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Bauters","sequence":"additional","affiliation":[{"name":"Institut d\u2019H\u00e9matologie-Transfusion, Centre de biologie Pathologie, Lille University Hospital, CHU Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Labreuche","sequence":"additional","affiliation":[{"name":"ULR 2694 - METRICS: \u00c9valuation des technologies de sant\u00e9 et des pratiques m\u00e9dicales, Lille University Hospital, CHU Lille, Lille, 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