Impact of the 2023 ACR/EULAR antiphospholipid syndrome criteria in 1200 women with prior obstetric antiphospholipid syndrome
Por:
Alijotas-Reig, J, Esteve-Valverde, E, Sáez-Comet, L, Anunciación-Llunell, A, Ferrer-Oliveras, R, Lefkou, E, Mekinian, A, Belizna, C, Hoxha, A, Tincani, A, Marozio, L, Espinosa, G, de Carolis, S, Udry, S, Latino, JO, Llurba, E, Chighizola, CB, Gerosa, M, Pengo, V, Lundelin, K, Rovere-Querini, P, Canti, V, Mayer-Pickel, K, Reshetnyak, T, Tabacco, S, Stojanovich, L, Gonçalves, BA, Morales-Perez, S, Miró-Mur, F
Publicada:
1 may 2026
Resumen:
Aim: The goal of a high specificity led to a loss of sensitivity in the new 2023 ACR/EULAR APS classification criteria, and mainly affecting obstetric clinical phenotype (OAPS). To reclassify a cohort of 1,200 women diagnosed of OAPS based on the Sydney classification criteria by applying the 2023 ACR/EULAR APS criteria. Methods: The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS) with 1,200 women that fulfil the Sydney classification criteria were reanalysed according to the obstetric (domain 4) and laboratory domain 8 of the new classification criteria. Results: When our cases were re-classified by applying the clinical criteria of domain 4, 816 cases (68%) would be excluded, leaving 384 cases (32%). The criteria that moderate to high IgM positivity is insufficient to classify patients, it led to a drop of additional 46 women, with a final number of excluded cases of 862 (71.83%), leaving only 338 cases (28.17%). Furthermore, the implementation of 40 units threshold discarded 86 women with an antiphospholipid antibody positivity above the 99th percentile cutoff. Eventually, from the 1,200 cases initially classified by the Sydney criteria, only 256 (21,33%) will remain. Conclusion: The 2023 ACR/EULAR classification criteria substantially reduce the proportion of women with prior obstetric APS who remain classifiable in our cohort. Although these findings highlight a marked decrease in case identification compared with the Sydney criteria, the potential clinical and research implications of this reduction warrant further evaluation in prospective studies.
Filiaciones:
Alijotas-Reig, J:
Univ Autonoma Barcelona, Dept Med, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Vall dHebron Univ Hosp, Dept Internal Med, Syst Autoimmune Dis Unit, Barcelona, Spain
Vall dHebron Inst Recerca, Syst Autoimmune Dis Res Unit, Barcelona, Spain
Esteve-Valverde, E:
Hosp St Camil, Dept Internal Med, Syst Autoimmune Dis Unit, Consorci Sanit Garraf, Barcelona, Spain
Ferrer-Oliveras, R:
Hosp Univ Quiron salud, Obstet Dept, High Risk Unit, Barcelona, Spain
Lefkou, E:
Hippokration Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
Mekinian, A:
Sorbonne Univ, Hop St Antoine, AP HP,Biotherapy Dept DHU i2B, Serv Med Interne & Inflammat Immunopathol, Paris, France
Belizna, C:
Univ Hosp Angers, Vasc & Coagulat Dept, Angers, France
Hoxha, A:
Univ Padua, Thrombot & Haemorrhag Ctr, Internal Med Unit, Padua, Italy
Tincani, A:
Univ Brescia, Dept Clin & Expt Sci, Rheumatol & Clin Immunol Unit, Spedali Civili, Brescia, Italy
Marozio, L:
Univ Torino, Dept Obstet & Gynaecol, Turin, Italy
Espinosa, G:
Univ Barcelona, Hosp Clin, Syst Autoimmune Dis Serv, Barcelona, Spain
Udry, S:
Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, Argentina
Latino, JO:
Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, Argentina
Llurba, E:
Univ Hosp Santa Creu i St Pau, Obstet & Gynaecol Dept, High Risk Unit, Barcelona, Spain
Chighizola, CB:
Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy
ASST G Pini CTO, Unit Pediat Rheumatol, Milan, Italy
Gerosa, M:
Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
Pengo, V:
Univ Padua, Dept Cardiac Thorac & Vasc Sci, Cardiol Unit, Padua, Italy
Lundelin, K:
Univ Turku, Fac Med, Dept Pediat, Turku, Finland
Rovere-Querini, P:
IRCCS Osped San Raffaele, Internal Med, Milan, Italy
IRCCS Osped San Raffaele, Div Immunol Transplantat & Infect Dis, Milan, Italy
Canti, V:
IRCCS Osped San Raffaele, Internal Med, Milan, Italy
IRCCS Osped San Raffaele, Div Immunol Transplantat & Infect Dis, Milan, Italy
Mayer-Pickel, K:
Med Univ Graz, Dept Obstet, Graz, Austria
Reshetnyak, T:
VA Nasonova Res Inst Rheumatol, Dept Syst Rheumat Dis, Moscow, Russia
Tabacco, S:
Sapienza Univ Rome, Dept Gynecol Obstet & Urol, Rome, Italy
Stojanovich, L:
Univ Belgrade, Univ Med Ctr, Belgrade, Serbia
Gonçalves, BA:
Univ Autonoma Barcelona, Dept Med, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
Vall dHebron Univ Hosp, Dept Internal Med, Syst Autoimmune Dis Unit, Barcelona, Spain
Morales-Perez, S:
Hosp St Joan Despi Moises Broggi, Dept Internal Med, Barcelona, Spain
Hosp Univ Miguel Servet, Dept Internal Med, Zaragoza, Spain
Catholic Univ, Gemelli Hosp, Dept Gynaecol, Rome, Italy
Hosp Univ Miguel Servet, Dept Internal Med, Zaragoza, Spain
Catholic Univ, Gemelli Hosp, Dept Gynaecol, Rome, Italy
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