AB0295 TREATMENT OF HIGH RISK/REFRACTORY OBSTETRIC ANTIPHOSPHOLIPID SYNDROME. A SINGLE CENTRE EXPERIENCE

Background: The most efficacious strategy to manage pregnant patients with antiphospholipid syndrome (APS) who are at high risk of adverse pregnancy outcomes ± refractory conventional heparin/low-dose aspirin treatment is currently unknown (1, 2). Objectives: purposes this study were investigate the efficacy and safety a second-line protocol administered in addition twice daily low molecular weight heparin low-dose affected high-risk primary APS. Methods: Patients included if satisfying following criteria were: 1) presence triple antibody positivity (IgG/IgM anticardiolipin + IgG/IgM anti-β2 Glycoprotein I antibodies lupus anticoagulant), 2) previous thrombosis and/or history one or more early severe complications. weekly plasmapheresis immunoadsorption fortnightly 1g/kg intravenous immunoglobulins. Results: Twenty-four pregnancies occurring between 2002 2019 19 APS patients, (mean age 35.1 3.5 SD) monitored. Triple was detected all cases (100%). Seven these women (36.8%) had thrombosis, five (26.3%) failed associated complications seven both clinical criteria. Twenty- three (95.8%) produced live neonates (13 females 10 males), born 26 th 38 week gestation 33.6 SD); birth percentile 35.8 24.1 SD mean Apgar score 5 min 8.7 1.1 SD. Due premature (24 week) complicated by fetal sepsis, (4.2%) negative outcome. During treated there no episodes thrombosis; (20.8%) maternal during puerperium four (16.6%), followed complete recovery after delivery. No side-effects registered. Conclusion: Given rate it, described here could be taken into consideration when therapy being evaluated. References: [1]Tektonidou MG, et al. Ann Rheum Dis 2019; 0 :1–9. doi:10.1136/annrheumdis-2019-215213 [2]Giacomelli Autoimmun Rev. 2020;102738. doi.org/10.1016/j.autrev.2020.102738 Disclosure Interests: None declared