Prevalence of antiphospholipid antibodies in Behçet’s disease: A systematic review and meta-analysis

Md Asiful Islam; Sayeda Sadia Alam; Shoumik Kundu; A. H.M. Safayet Ullah Prodhan; Shahad Saif Khandker; Tatiana Reshetnyak; Przemysław J. Kotyla; Rosline Hassan; Tareq Hossan

doi:10.1371/journal.pone.0227836

Prevalence of antiphospholipid antibodies in Behçet’s disease: A systematic review and meta-analysis

Md Asiful Islam, Sayeda Sadia Alam, Shoumik Kundu, A. H.M. Safayet Ullah Prodhan, Shahad Saif Khandker, Tatiana Reshetnyak, Przemysław J. Kotyla, Rosline Hassan, Tareq Hossan

Metabolism and Systems Science

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

Behçet’s disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)—including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg’s and Egger’s tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15–28.41, p<0.00001) and anti-β2-GPI antibodies (OR: 23.57, 95% CI: 1.31–423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65–293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg’s and Egger’s tests. This meta-analysis established that there is a significantly high prevalence of aPLs (i.e., aCL and anti-β2-GPI antibodies) in patients with BD when compared to controls.

Original language	English
Article number	e0227836
Journal	PLoS ONE
Volume	15
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0227836
Publication status	Published - Jan 2020

Bibliographical note

Publisher Copyright:
© 2020 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

Behçet’s disease
antiphospholipid antibodies
systematic review
meta-analysis

ASJC Scopus subject areas

General

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0227836

Cite this

@article{ba0a1448a3c6458191f7363c1040428c,

title = "Prevalence of antiphospholipid antibodies in Beh{\c c}et{\textquoteright}s disease: A systematic review and meta-analysis",

abstract = "Beh{\c c}et{\textquoteright}s disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)—including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg{\textquoteright}s and Egger{\textquoteright}s tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15–28.41, p<0.00001) and anti-β2-GPI antibodies (OR: 23.57, 95% CI: 1.31–423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65–293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg{\textquoteright}s and Egger{\textquoteright}s tests. This meta-analysis established that there is a significantly high prevalence of aPLs (i.e., aCL and anti-β2-GPI antibodies) in patients with BD when compared to controls.",

keywords = "Beh{\c c}et{\textquoteright}s disease, antiphospholipid antibodies, systematic review, meta-analysis",

author = "Islam, {Md Asiful} and Alam, {Sayeda Sadia} and Shoumik Kundu and {Safayet Ullah Prodhan}, {A. H.M.} and Khandker, {Shahad Saif} and Tatiana Reshetnyak and Kotyla, {Przemys{\l}aw J.} and Rosline Hassan and Tareq Hossan",

note = "Publisher Copyright: {\textcopyright} 2020 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2020",

month = jan,

doi = "10.1371/journal.pone.0227836",

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AU - Islam, Md Asiful

AU - Alam, Sayeda Sadia

AU - Kundu, Shoumik

AU - Safayet Ullah Prodhan, A. H.M.

AU - Khandker, Shahad Saif

AU - Reshetnyak, Tatiana

AU - Kotyla, Przemysław J.

AU - Hassan, Rosline

AU - Hossan, Tareq

N1 - Publisher Copyright: © 2020 Islam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2020/1

Y1 - 2020/1

N2 - Behçet’s disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)—including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg’s and Egger’s tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15–28.41, p<0.00001) and anti-β2-GPI antibodies (OR: 23.57, 95% CI: 1.31–423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65–293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg’s and Egger’s tests. This meta-analysis established that there is a significantly high prevalence of aPLs (i.e., aCL and anti-β2-GPI antibodies) in patients with BD when compared to controls.

AB - Behçet’s disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements (i.e., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)—including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg’s and Egger’s tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15–28.41, p<0.00001) and anti-β2-GPI antibodies (OR: 23.57, 95% CI: 1.31–423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65–293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg’s and Egger’s tests. This meta-analysis established that there is a significantly high prevalence of aPLs (i.e., aCL and anti-β2-GPI antibodies) in patients with BD when compared to controls.

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KW - meta-analysis

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Prevalence of antiphospholipid antibodies in Behçet’s disease: A systematic review and meta-analysis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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