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In reply

We appreciate Drs Pechlaner and Wiedermann's interest in our article¹ as well as their provocative clinical questions. Our work focused on establishing the impact of APS in the natural history of systemic lupus erythematosus (SLE). Thus we did not analyze the utility of aPL assay in predicting an adverse outcome before the development of APS, although this would be certainly relevant for clinicians looking after patients with lupus.

The great variability of different tests to detect aPL is well known. Even more, SLE activity may induce transient positivity of aPL. However, all our patients with aPL had at least 2 positive determinations—this was our working definition for aPL positivity—and most of them had more than 2. Our aim was to identify those patients whose antibodies had a real pathogenic potential.

If we analyze 15-year survival rates according to aPL status, there is a trend toward decreased survival in . . . [Full Text of this Article]

Guillermo Ruiz-Irastorza, MD, PhD; Maria-Victoria Egurbide, MD; Ciriaco Aguirre, MD, PhD

Correspondence: Dr Ruiz-Irastorza, Servicio De Medicina Interna, Hospital De Cruces, Universidad Del Pais Vasco-Euskal Herriko, Unibertsitatea, 48903 Bizkaia, Spain (r.irastorza@euskalnet.net).

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