In the early days of understanding APS, said Dr. Shoenfeld, it was thought that complement was not as important as it was in systemic lupus erythematosus (SLE). The importance of raised complement seen in studies of APS would often be discounted or neglected in comparison to SLE.
However, “slowly, slowly” it has been found that “complement [in APS] is activated very similarly to SLE,” Dr. Shoenfeld noted.
“I think that it’s important to assess the component levels,” Dr. Lini said in discussion. “This is needed to be done in the preconception counseling for APS and aPL carrier patients.”
Determining whether there is single, double, or even triple aPL positivity could be useful in guiding clinical decisions.
“If we have triple positivity, that could mean that there may be a more immunologic activation of the system and that it could be useful to administrate hydroxychloroquine [to] those patients who would like to have a pregnancy,” Dr. Lini suggested.
Plus, in those with decreased complement levels, “this could be a very useful tool” to identify where something could go wrong during their pregnancy.
The study had no outside funding. Dr. Lini and Dr. Shoenfeld disclosed no relevant financial relationships.
A version of this article first appeared on Medscape.com.