TOPLINE:

In patients with antiphospholipid syndrome (APS), isolated antiphospholipid antibodies, and/or systemic lupus erythematosus (SLE), elevated plasma levels of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) at baseline were associated with an increased risk for thrombosis, obstetric events, or death.

METHODOLOGY:

• In this prospective cohort study, researchers evaluated whether baseline plasma sTREM-1 levels predicted clinical outcomes in 108 adults with APS, isolated antiphospholipid antibodies, and/or SLE (mean age, 44.8 years; 78% women).
• Patients were recruited at a French tertiary care referral centre and followed up for a median of 54 months between 2011 and 2019, and they were monitored every 6 months and at any new event.
• The main outcome was a composite of vascular thrombosis, obstetric events, or death.

TAKEAWAY:

• Among 23 patients who experienced an event during follow-up, 15 had thromboses, five died, and three who were women had obstetric events.
• Plasma sTREM-1 levels ≥ 1578 pg/mL were associated with an increased risk for the onset of an event (hazard ratio [HR], 7.54; 95% CI, 2.44-23.31).
• Independent predictors for the occurrence of an event were sTREM-1 levels ≥ 1578 pg/mL (adjusted HR, 3.79; P = .041) and the presence of kidney disease (adjusted HR, 2.47; P = .043).
• Patients with primary APS had significantly higher sTREM-1 levels than those with isolated antiphospholipid antibodies (mean, 363.7 vs 149.4 pg/mL; P = .02).

IN PRACTICE:

"[The study] results suggest that targeting the TREM-1 pathway could represent a new approach to the treatment of APS," the authors of the study wrote.

SOURCE:

This study was led by Virginie Dufrost, National Referral Centre for Rare Vascular and Systemic Autoimmune Diseases, Nancy, France. It was published online on November 13, 2025, in Lupus.

LIMITATIONS:

The study population was heterogeneous, comprising different patient groups. The sample size was relatively small, with very few patients having high sTREM-1 levels. The low number of events required the use of a composite endpoint.

DISCLOSURES:

This study received funding from Centre Hospitalier Régional de Nancy, Institut National de la Santé et de la Recherche Médicale, and Association des chefs de service du CHRU de Nancy. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.