Impact of the 2023 ACR/EULAR antiphospholipid syndrome criteria in 1200 women with prior obstetric antiphospholipid syndrome
Alijotas-Reig, Jaume (Vall d'Hebron Institut de Recerca (VHIR))
Esteve-Valverde, Enrique (Hospital Sant Camil (Barcelona))
Sáez-Comet, Luis (Hospital Universitario Miguel Servet (Saragossa))
Anunciación-Llunell, Ariadna (Vall d'Hebron Institut de Recerca (VHIR))
Ferrer-Oliveras, Raquel (Hospital Universitario Quirónsalud (Barcelona))
Lefkou, Eleftheria (Hippokration General Hospital of Thessaloniki (Grècia))
Mekinian, Arsène (Sorbonne Universités)
Belizna, Cristina (University Hospital Angers)
Hoxha, Ariela (Università di Padova)
Tincani, Angela (Azienda Ospedaliera Spedali Civili di Brescia (Brescia, Itàlia))
Marozio, Luca (Università di Torino)
Espinosa, Gerard (Hospital Clínic i Provincial de Barcelona)
Carolis, Sara de (Gemelli Hospital (Roma, Itàlia))
Udry, Sebastian (Dr. Carlos G. Durand Hospital (Buenos Aires, Argentina))
Latino , Jose Omar (Dr. Carlos G. Durand Hospital (Buenos Aires, Argentina))
Llurba, Elisa (Institut de Recerca Sant Pau)
Chighizola, Cecilia B. (Università degli Studi di Milano)
Gerosa, Maria (Università degli Studi di Milano)
Pengo, Vittorio (Università di Padova)
Lundelin, Krista (University of Turku (Finlàndia))
Rovere-Querini, Patrizia (IRCCS Ospedale San Raffaele (Milà, Itàlia))
Canti, Valentina (IRCCS Ospedale San Raffaele (Milà, Itàlia))
Mayer-Pickel, Karoline (Medical University of Graz)
Reshetnyak, Tatiana (Nasonova Research Institute of Rheumatology (Moscú, Rússia))
Tabacco, Sara (Università degli Studi di Roma "La Sapienza")
Stojanovich, Ljudmila (University of Belgrade (Sèrbia))
Jesus Gonçalves, Bruna Ariana del (Vall d'Hebron Institut de Recerca (VHIR))
Morales-Pérez, Stephanie (Hospital de Sant Joan Despí Moisès Broggi)
Miró-Mur, Francesc (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2026
Resumen:	AimThe 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. MethodsThe 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. ResultsWhen 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. ConclusionThe 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.
Nota:	Altres ajuts: acords transformatius de la UAB
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Antiphospholipid antibodies ; Antiphospholipid syndrome ; Obstetrics ; Classification criteria
Publicado en:	European Journal of Obstetrics and Gynecology and Reproductive Biology, 2026 , ISSN 1872-7654

DOI: 10.1016/j.ejogrb.2026.115055
PMID: 41797084

9 p, 1.3 MB

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