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Cohort studyThrombosis research · 2026

Descriptive analysis of the Nationwide START2 antiphospholipid registry: Clinical and laboratory characteristics of patients with persistently positive antiphospholipid antibodies.

Vittorio Pengo, Daniela Poli, Luca Sarti … Start2 Antiphospholipid Registry collaborators, all in Italy

Internal MedicineCohort study

Isolated lupus anticoagulant positivity linked to higher venous thromboembolism rates in antiphospholipid syndrome

Descriptive analysis of the Nationwide START2 antiphospholipid registry: Clinical and laboratory characteristics of patients with persistently positive antiphospholipid antibodies.

Vittorio Pengo … Start2 Antiphospholipid Registry collaborators, all in Italy

Thrombosis research · 2026

Background

The clinical significance of persistently positive antiphospholipid antibodies (aPLs) remains incompletely defined.

Purpose

To describe the clinical and laboratory characteristics of patients with confirmed aPL positivity enrolled in the nationwide START2 Antiphospholipid Registry.

Methods

Were categorized as Antiphospholipis Syndrome (Antiphospholipis Syndrome) or aPL carriers.

n = 500 enrolled patients

67%

Results

67%

isolated LA positivity carried the highest venous thromboembolism rate of any antibody pattern

n = 500 enrolled patients

More results

Women were overrepresented among carriers (76% vs 62%, p = 0.002).

Laboratory profiles were similarly distributed across Antiphospholipis Syndrome and carriers: triple positivity (43% vs 44%), double positivity (13% vs 12%), and isolated LA positivity (23% vs 30%).

More results

After a first venous thromboembolism, most Antiphospholipis Syndrome patients received warfarin (62%), whereas arterial Antiphospholipis Syndrome was treated with either warfarin (51%) or aspirin (37%).

Among carriers, aspirin was the preferred prophylactic strategy (45%).

“

Conclusion · 1 of 2

Triple, double, and LA positive only represent the most common laboratory patterns. LA positivity omly shows a disproportionately high rate of venous thromboembolism.

Conclusion · 2 of 2

Non-criteria manifestations remain more common in Antiphospholipis Syndrome. Substantial variability persists in antithrombotic management, underscoring the need for prospective treatment trials.

Post

Descriptive analysis of the Nationwide START2 antiphospholipid registry: Clinical and laboratory characteristics of patients with persistently positive antiphospholipid antibodies.

Isolated lupus anticoagulant positivity linked to higher venous thromboembolism rates in antiphospholipid syndrome

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