Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (6): 1107-1112. doi: 10.19723/j.issn.1671-167X.2025.06.014

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Clinic behavior and therapeutic status of patients with antiphospholipid syndrome

Yanyan LI1,2, Xiangjun LIU1, Gongming LI1,3, Chun LI1,*(), Yuan JIA1,*()   

  1. 1. Department of Rheumatology & Immunology, Peking University People's Hospital, Beijing 100044, China
    2. Department of Rheumatology & Immunology, The Third People's Hospital of Zhengzhou, Zhengzhou 450000, China
    3. Rheumatology Department, Linyi Hospital of Traditional Chinese Medicine, Linyi 276000, Shandong, China
  • Received:2025-08-18 Online:2025-12-18 Published:2025-10-17
  • Contact: Chun LI, Yuan JIA
  • Supported by:
    the Beijing Natural Science Foundation(7192211); the National Basic Research Program of China(2022YFC3602000)

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Abstract:

Objective: To investigate and analyze the clinical behavior and therapeutic status of patients with antiphospholipid syndrome (APS). Methods: Patients diagnosed with APS between September 2021 and October 2025 were enrolled in this investigation. Data collection included: demographic characteristics, disease duration, initial presenting symptoms, departments of first visit and diagnosis, time of the first visit and definite diagnosis, the interval of follow-up, previous and current medications. Assessments using the 36-item short form health survey (SF-36), hospital anxiety and depression scale (HADS), and general medication adherence scale (GMAS) were also conducted. Age- and gender-matched healthy controls were selected and completed parallel SF-36 and HADS evaluations during the same period. Results: In the study, 196 patients with APS were investigated. The median age of onset was 36 years, the male to female ratio was 1:6.8, and median disease duration was 3.0 years. Rheumatology & Immunology was the most common department for the first hospital visit (33.2%, 65/196), followed by Hematology (21.9%) and Reproductive Endocrinology and Infertility Center (18.4%). Other departments included Neurology (5.6%), Vascular Surgery (5.1%), and Emergency (4.1%). The median time from symptom onset to APS diagnosis was 6.0 months, with 32.1%(63/196) of patients experiencing a diagnostic delay of over one year. Regarding follow-up adherence, 56.6% (111/196) of patients with APS maintained regular follow-ups at intervals of ≤3 months, while 7.1% (14/196) of the patients visited their doctor less than once a year. The primary pharmacological treatments for the APS patients included hydroxychloroquine, warfarin and other anticoagulants, and antiplatelet agents. According to the GMAS assessment, 76.1% of the patients demonstrated high or good medication adhe-rence. Among all SF-36 domains, the scores of general health (GH) in the APS patients were significantly lower compared with healthy controls (P < 0.05). According to the HADS, the proportion of anxiety symptoms was significantly higher in the APS patients compared with healthy controls (13.8% vs. 6.7%, P < 0.05). Conclusion: In this study, delayed diagnosis in APS remained prevalent. Compared with healthy controls, the APS patients exhibited significantly impaired physical function and elevated anxiety symptoms. Regular follow-up monitoring should be emphasized, and greater attention must be paid to psychoeducational interventions.

Key words: Antiphospholipid syndrome, Cross-sectional studies, Office visits, Quality of life

CLC Number: 

  • R593.2

Figure 1

Distribution of first-visit departments in patients with antiphospholipid syndrome"

Figure 2

Initial presenting complaints of patients with antiphospholipid syndrome"

Figure 3

Distribution of follow-up intervals in patients with antiphospholipid syndrome"

Table 1

Medication profiles of patients with antiphospholipid syndrome"

Drugs Previous, n (%) Current, n (%)
Hydroxychloroquine 177 (90.3) 152 (77.6)
Antiplatelets and anticoagulants 173 (88.3) 141 (71.9)
  Aspirin 143 (73.0) 94 (48.0)
  Low molecular weight heparin 91 (46.4) 40 (20.4)
  Rivaroxaban 22 (11.2) 6 (3.1)
  Warfarin 45 (23.0) 35 (17.9)
Glucocorticoids 117 (59.7) 76 (38.8)
Immunosuppressants 56 (28.6) 41 (20.9)
  Mycophenolate 32 (16.3) 19 (9.7)
  Cyclophosphamide 14 (7.1) 1 (0.5)
  Methotrexate 6 (3.1) 2 (1.0)
  Leflunomide 7 (3.6) 2 (1.0)
  Ciclosporin 9 (4.6) 8 (4.1)
  Tacrolimus 8 (4.1) 8 (4.1)
Immunoglobulin 21 (10.7) 1 (0.5)
Rituximab 13 (6.6) 4 (2.0)
Statins 17 (8.7) 13 (6.6)
Drug-free 0 (0) 11 (5.6)

Table 2

Quality of life assessment using the SF-36 in patients with antiphospholipid syndrome and healthy controls"

Sub-domain SF-36 P
APS patients (n=196) Healthy controls (n=150)
Physical functioning 95 (85, 100) 95 (90, 100) 0.15
Role physical 100 (50, 100) 100 (75, 100) 0.07
Bodily pain 72 (62, 100) 72 (62, 100) 0.06
General health 57.0 (40.0, 77.0) 65.0 (52.0, 77.8) < 0.01*
Vitality 60 (50, 75) 65 (50, 75) 0.33
Social functioning 87.5 (62.5, 100.0) 87.5 (62.5, 100.0) 0.65
Role emotional 100.0 (33.3, 100.0) 100.0 (33.3, 100.0) 0.57
Mental health 68 (49, 80) 68 (55, 76) 0.28

Table 3

HADS scores in patients with antiphospholipid syndrome and healthy controls"

HADS scores APS patients
(n=196)
Healthy controls
(n=150)
P
HADS-A, M (P25, P75) 5 (2, 8) 4 (2, 7) 0.20
HADS-A>10, n (%) 27 (13.8) 10 (6.7) 0.03*
HADS-D, M (P25, P75) 4 (1, 7) 3 (1, 7) 0.96
HADS-D>10, n (%) 19 (19.7) 14 (9.3) 0.91
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