From the Guidelines
Yes, Beta-2 Glycoprotein (B2GP) antibody is indicated in Systemic Lupus Erythematosus (SLE) as it is one of the antiphospholipid antibodies used to diagnose antiphospholipid syndrome (APS), which is a common comorbidity in SLE patients 1.
Key Points
- The presence of B2GP antibody, along with other antiphospholipid antibodies such as lupus anticoagulant (LA) and anticardiolipin antibody (aCL), is used to diagnose APS in SLE patients 2.
- A high-risk antiphospholipid profile, which includes triple-positive antiphospholipid testing (LA, aCL, and B2GP) or double-positive (any combination), is associated with an increased risk of thrombosis and stroke in SLE patients 3.
- Prophylactic treatment with aspirin (75-100 mg daily) is recommended to reduce the risk of stroke in SLE patients with a high-risk antiphospholipid profile, including those with B2GP antibody positivity 3.
- The American College of Rheumatology guideline recommends testing for antiphospholipid antibodies, including B2GP, in SLE patients with suggestive histories or physical findings, and in patients with a lower likelihood of positive results, the decision to test should be made by physician-patient discussion 1.
Clinical Implications
- SLE patients with B2GP antibody positivity should be closely monitored for signs of thrombosis and stroke, and prophylactic treatment with aspirin should be considered to reduce the risk of these complications 3.
- The diagnosis of APS in SLE patients should be made based on a combination of clinical and laboratory criteria, including the presence of antiphospholipid antibodies such as B2GP, LA, and aCL 2, 1.
From the Research
Beta-2 Glycoprotein (B2GP) Antibody in Systemic Lupus Erythematosus (SLE)
- The presence of anti-beta2-glycoprotein I (anti-beta2-GPI) antibodies in patients with SLE has been investigated in several studies 4, 5, 6, 7, 8.
- These studies suggest that anti-beta2-GPI antibodies are frequently found in patients with SLE, with a prevalence ranging from 15% to 36.8% 4, 5, 6.
- The clinical significance of anti-beta2-GPI antibodies in SLE patients has been evaluated, with some studies suggesting an association with thrombosis, intrauterine fetal loss, and other clinical manifestations of antiphospholipid syndrome (APS) 5, 6, 7, 8.
- The measurement of anti-beta2-GPI antibodies has been proposed as a useful tool for identifying patients with SLE at higher risk for venous and arterial thrombosis 6.
- The sensitivity and specificity of anti-beta2-GPI antibodies for the diagnosis of APS in SLE patients have been reported to be around 60% and 80%, respectively 7.
- Some studies have suggested that the presence of anti-beta2-GPI antibodies may be associated with a unique form of SLE, characterized by a higher risk of thrombosis and other clinical manifestations of APS 5, 8.
Association with Clinical Manifestations
- The presence of anti-beta2-GPI antibodies has been associated with an increased frequency of thrombosis, intrauterine fetal loss, and other clinical manifestations of APS in SLE patients 5, 6, 7, 8.
- Some studies have suggested that the titer of anti-beta2-GPI antibodies may fluctuate with disease activity in SLE patients 8.
- The measurement of anti-beta2-GPI antibodies has been proposed as a useful tool for monitoring the clinical course in patients with SLE 8.
Comparison with Other Antibodies
- The presence of anti-beta2-GPI antibodies has been compared with other antibodies, such as anticardiolipin antibodies (aCL), in SLE patients 4, 5, 6, 7, 8.
- Some studies have suggested that anti-beta2-GPI antibodies may be more useful than aCL for identifying patients with SLE at higher risk for thrombosis and other clinical manifestations of APS 6, 8.