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Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION): 10-Year Update

Research output: Contribution to journalReview articlepeer-review

APS ACTION Executive Committee

Original languageEnglish
Article number45
JournalCurrent Rheumatology Reports
Issue number6
PublishedJun 2021

Bibliographical note

Funding Information: Funding The APS ACTION registry was created using REDCAP provided by the Clinical and Translational Science Center at Weill Cornell Medical College (CTSC grant UL1 TR000457). APS ACTION has received partial support from a private donor, APS Foundation of America, APS Support UK, and APS Foundation of Australia. Antiphospholipid antibody kits used at Core laboratories have been donated by INOVA Diagnostics and Instrumentation Laboratory. ML Bertolaccini is supported by the King’s BHF Centre for Award Excellence RE/18/2/34213. Funding Information: The first major clinical trial designed by APS ACTION was the international, multicenter, randomized controlled trial (RCT) assessing the efficacy of hydroxychloroquine (HCQ) for primary thrombosis prevention in persistently aPL-positive but thrombosis-free patients with no other systemic autoimmune diseases. The study, partially supported by New York Community Trust, was terminated earlier than the planned completion date due to the low patient recruitment rate exacerbated by the prolonged manufacturing shortage and price increase of HCQ. Given that a small number of patients with a relatively short follow-up were enrolled in this RCT, and no patients developed thrombosis, we were not able to accurately assess the effectiveness of HCQ for primary thrombosis prevention in persistently aPL-positive patients with no other systemic autoimmune diseases. The details of the study design, results, and challenges have been addressed elsewhere [19]. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Purpose of Review: APS ACTION is an international research network created to design and conduct large-scale, multicenter research in persistently antiphospholipid antibody (aPL)–positive patients. Given the expanding research activities of the network in the last decade since its creation, the purpose of this article is to review the scientific contributions of APS ACTION as well as future directions. Recent Findings: APS ACTION has achieved increased international collaboration with internal and external investigators for outcome, interventional, and mechanistic antiphospholipid syndrome (APS) studies. This has been linked to substantial progress in Core laboratory work, which has demonstrated that laboratories can achieve good agreement in performance of aPL assays by use of the same reagents, analyzer type, and protocols. Summary: APS ACTION will continue to identify gaps in the existing aPL/APS literature, design mechanistic studies to elucidate underlying mechanisms, and conduct prospective, large-scale clinical studies, all for the ultimate goal of early diagnosis and improved management of aPL-positive patients.

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