POS0724 GENDER DIFFERENCES IN THROMBOTIC PRIMARY ANTIPHOSPHOLIPID SYNDROME IN A LARGE COHORT OF PATIENTS FROM FOUR EUROPEAN CENTERS

Background: Autoimmune diseases occur more frequently in females and their course severity can be affected by gender. Antiphospholipid syndrome (APS) is a systemic autoimmune disorder which antiphospholipid antibodies (aPL) exert pathogenic role resulting vascular thrombosis and/or pregnancy morbidities. Data about gender differences thrombotic APS (t-APS) are still scarce 1,2 . Objectives: To evaluate the frequency, disease expression between males primary t-APS. Methods: Retrospective study enrolling subjects with formal diagnosis of (Miyakis 2006) at onset. Women who presented obstetric events as first aPL-related manifestation were excluded. All patients followed from 1967 to 2019 four European centers: three French centers one Italian center. Results: The included 433 (68% females, 32% males). Median age t-APS onset [31 (24-46) vs 41 (29-53) years, p<0.001 ] [34 (27-50) 46 (34-57) was significantly lower females. most common presenting manifestations venous (60%) arterial (37%) catastrophic (3%). Venous frequent women compared men (64% 51% p:0.012 OR:1.7 [1.1-2.5]). Sites included: limbs (35%), pulmonary (17%), cerebral (3%), portal inferior cava (2%) retinal (1%) veins, without differences. among (43% 34% p:0.053 ). Strokes (27%) myocardial infarctions (4%) manifestations, (2%), retina abdominal organs (1%). Noteworthy, only visceral ischemia. During follow-up, new occurred 41% (179/433). 33% out them had least two episodes these especially (22% 10% p:0.001 OR:2.5 [1.3-4.8]). New mostly same type, but ⅓ switch side viceversa, no Complete aPL profile available 357 subjects: single positivity, 24% double positivity 43% triple men. About 80% concomitant risk factor (RF) for thrombosis. Established cardiovascular RFs represented shown table 1. In women, estrogenic exposure main RFs, present almost 40% them. Table MALES n= 137 FEMALES 296 P OR [IC 95%] Traditional n (% ) Smoke 66 (48) 81 (27) <0.001 2.5 [1.6-3.8] Arterial hypertension 59 (43) 75 (25) 2.2 [1.5-3.4] Dyslipidemia 52 (38) 72 (24) 0.004 1.9 [1.2-2.9] Diabetes 16 (12) 15 (5) 0.014 [1.8-5.1] Obesity 13 (10) 38 (13) ns Other thrombophilic factors, Estrogenic stimuli* 0 116 (39) - Trauma / surgery immobilization 21 (15) 32 (11) Congenital thrombophilia 9/94 33/204 (16) using contingency tables, p value calculated Chi-Squared or Fisher exact test. *= hormonal therapy, pregnancy, post-partum Conclusion: This gender-oriented analysis showed that event younger on side, while mainly events, later life suffered recurrent events. No observed distribution profile. different frequency groups could attributed presence additional rather than biological gender-specific issues. However, it should underlined some such use estrogens classic exclusive other, making difficult assess link causality References: [1]JF de Carvalho. Rheumatol Int. 2011. [2]LJ Jara. Lupus. 2005. Disclosure Interests: None declared