{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:54:29Z","timestamp":1790704469670,"version":"4.1.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to use cluster analysis (CA) to identify different clinical phenotypes among antiphospholipid antibodies (aPL)-positive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Alliance for Clinical Trials and International Networking (APS ACTION) Registry includes persistently positive aPL of any isotype based on the Sydney antiphospholipid syndrome (APS) classification criteria. We performed CA on the baseline characteristics collected retrospectively at the time of the registry entry of the first 500 patients included in the registry. A total of 30 clinical data points were included in the primary CA to cover the broad spectrum of aPL-positive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 497 patients from international centres were analysed, resulting in three main exclusive clusters: (a) female patients with no other autoimmune diseases but with venous thromboembolism (VTE) and triple-aPL positivity; (b) female patients with systemic lupus erythematosus, VTE, aPL nephropathy, thrombocytopaenia, haemolytic anaemia and a positive lupus anticoagulant test; and (c) older men with arterial thrombosis, heart valve disease, livedo, skin ulcers, neurological manifestations and cardiovascular disease (CVD) risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on our hierarchical cluster analysis, we identified different clinical phenotypes of aPL-positive patients discriminated by aPL profile, lupus or CVD risk factors. Our results, while supporting the heterogeneity of aPL-positive patients, also provide a foundation to understand disease mechanisms, create new approaches for APS classification and ultimately develop new management approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203320940776","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T01:29:44Z","timestamp":1595554184000},"page":"1353-1363","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Cluster analysis for the identification of clinical phenotypes among antiphospholipid antibody-positive patients from the APS ACTION Registry"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9326-6881","authenticated-orcid":false,"given":"St\u00e9phane","family":"Zuily","sequence":"first","affiliation":[{"name":"Vascular Medicine Division and Regional Competence Centre for Systemic And Autoimmune Diseases, Nancy Academic Hospital, Nancy, France"},{"name":"Inserm UMR_S 1116, Lorraine University, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Clerc-Urm\u00e8s","sequence":"additional","affiliation":[{"name":"ESPRI-BioBase, Platform of Clinical Research Support PARC (MDS unity), Nancy Academic Hospital, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Bauman","sequence":"additional","affiliation":[{"name":"ESPRI-BioBase, Platform of Clinical Research Support PARC (MDS unity), Nancy Academic Hospital, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danieli","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Faculty of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1266-9441","authenticated-orcid":false,"given":"Savino","family":"Sciascia","sequence":"additional","affiliation":[{"name":"Centre of Research of Immunopathology and Rare Diseases, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2064-6071","authenticated-orcid":false,"given":"Vittorio","family":"Pengo","sequence":"additional","affiliation":[{"name":"Thrombosis Research Laboratory, Department of Cardiac Thoracic and Vascular Sciences, and Public Health, University of Padova; Arianna Foundation on Anticoagulation, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-0975","authenticated-orcid":false,"given":"Maria G","family":"Tektonidou","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Autoimmune Diseases Research Unit, Department of Internal Medicine, Hospital Universitario Cruces, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gerosa","sequence":"additional","affiliation":[{"name":"Clinical Rheumatology Unit, Research Center for Adult and Pediatric Diseases, Department of Clinical Sciences and Community Health, ASST Pini-CTO, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Michael Belmont","sequence":"additional","affiliation":[{"name":"School of Medicine, New York University, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5653-4293","authenticated-orcid":false,"given":"Maria Angeles 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University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-5094","authenticated-orcid":false,"given":"D Ware","family":"Branch","sequence":"additional","affiliation":[{"name":"University of Utah and Intermountain Healthcare, Salt Lake City, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Ramires de","family":"Jesus","sequence":"additional","affiliation":[{"name":"Departamento de Obstetr\u00edcia, Hospital Universit\u00e1rio Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Nalli","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-5373","authenticated-orcid":false,"given":"Michelle","family":"Petri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricard","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases, Hospital Cl\u00ednic Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S","family":"Knight","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, University of 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