2023 ACR/EULAR classification criteria in existing research cohorts: an international study
Open accessAbstract
Objective: To assess the impact of the updated ACR/EULAR APS classification criteria on two large research cohorts. Methods: Consecutive patients who tested persistently positive for at least one aPL in the last three years were enrolled. The first APS Sydney index event was considered and computed for the comparison between Sydney and 2023 APS criteria. When computing the 2023 APS criteria, additional manifestations were also considered. Results: The cohort comprised 249 patients (185 with APS and 64 aPL carriers according to Sydney criteria). The 185 patients had as first index event venous thrombosis in 55 cases (29.8%), arterial thrombosis in 63 (34%) and pregnancy morbidity in 67 (36.2%). When applying the updated criteria, 90 subjects (48.7%) failed to reach the composite score of the new criteria. The percentage of thrombotic APS per Sydney criteria decreased from 47.3% to 34.9% because of high cardiovascular risk in 23 cases, IgM aPL profile in six cases and in two patients for both reasons. Patients with pregnancy morbidity decreased from 26.9% to 3.2% (39 cases of recurrent early pregnancy loss and 20 of fetal losses). Consequently, the percentage of aPL carriers increased from 26% to 61%. When looking at the disease evolution at follow-up, 32 additional patients out of 90 (35.6%) fulfilled the new APS criteria, after developing additional clinical manifestation following index event. Conclusion: When applying the new APS criteria to our research cohorts, not-negligible differences exist in patients’ classification. A multidisciplinary approach will be mandatory to assess the impact of the new criteria on research and, ultimately, patients’ care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with both traditional risk factors and positive aPL are at increased risk of thrombosis, although they do not fulfil classification criteria.
“these patients with both traditional risk factors and positive aPL are at increased risk of thrombosis. This increased risk should be acknowledged by clinicians, although patients do not fulfil classification criteria [11].”
From Insights into the 2023 ACR/EULAR antiphospholipid syndrome classification criteria: findings from a cohort of 205 patients with primary APS (2025) · cites this paper as [11]
The Impact of 2023 ACR/EULAR criteria for APS section reports aPL-positive patients with cardiovascular risk factors and prior thrombotic events who did not meet the new classification criteria. It does not establish that having both risk factors and positive aPL increases thrombosis risk relative to a comparison group. The Discussion cautions that classification criteria should not determine treatment decisions. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
EULAR recommendations for the management of antiphospholipid syndrome in adults
Tektonidou, M. G., Andreoli, L., Limper, M., Amoura, Z., Cervera, R., Costedoat-Chalumeau, N., Cuadrado, M. J., Dörner, T., Ferrer-Oliveras, R., Hambly, K., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-215213 · Cited by 1,261 · see citing works
Flagged first, then by citations
Research works printed but not linked: 10
- GR H. Thrombosis, abortion, cerebral disease, and the lupus anticoagulant. Br Med J (Clin Res Ed) 1983;287:1088-9.
- Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306.
- Barbhaiya M, Zuily S, Naden R et al. ; ACR/EULAR APS Classification Criteria Collaborators. 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Arthritis Rheumatol (Hoboken, NJ) 2023;75:1687-702.
- Barbhaiya M, Zuily S, Ahmadzadeh Y et al. ; New APS Classification Criteria Collaborators. Development of a new international antiphospholipid syndrome classification criteria phase I/II report: generation and reduction of candidate criteria. Arthritis Care Res (Hoboken) 2021;73:1490-501.
- Sciascia S, Amigo MC, Roccatello D, Khamashta M. Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances. Nat Rev Rheumatol 2017;13:548-60.
- Radin M, Ugolini-Lopes MR, Sciascia S, Andrade D. Extra-criteria manifestations of antiphospholipid syndrome: risk assessment and management. Semin Arthritis Rheum 2018;48:117-20.
- Desnoyers M, Dufrost V, Wahl D, Zuily S. Health-related quality of life in antiphospholipid syndrome: current knowledge and future perspectives. Curr Rheumatol Rep 2020;22:20.
- Alba P, Gómez-Puerta JA, Goycochea-Robles MV, Amigo MC. Organ Damage and Quality of Life in Antiphospholipid Syndrome. Curr Rheumatol Rep 2016;18:7.
- Tang Z, Shi H, Liu H-L et al. Correspondence on '2023 ACR/EULAR antiphospholipid syndrome classification criteria'. Ann Rheum Dis 2023;0:2023.
- Andreoli L, Bertsias GK, Agmon-Levin N et al. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis 2017;76:476-85.
Cited by
Sorted by citations
Zen, M., Tonello, M., Carta, F., Calligaro, A., Favaro, M., Del Ross, T., Hulej, G., Rahmé, Z., Ruffatti, A., & Doria, A. (2025) · Rheumatology · doi:10.1093/rheumatology/keae665 · Cited by 7 · see citing works
- Authors
- Foddai, S. G., Radin, M., Cecchi, I., Rubini, E., Barinotti, A., Alba, P., Gimen Alonso, C., Rossi, D., Roccatello, D., & Sciascia, S.
- Affiliations
- Ospedale San Giovanni Bosco (IT)
- Universidad Nacional de Córdoba (AR)
- Hospital Córdoba and Materno Neonatal, Cátedra de Medicina I UHMN 3, Universidad Nacional de Córdoba , Córdoba,
- Corresponding author
- Sciascia, Savino
- ORCID
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-01-30
- Volume
- 63
- Issue
- 10
- Pages
- 2770-2775
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- OpenAlex
- W4391919145
- Cited by
- 30
- References
- 1
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 10
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- antiphospholipid syndrome, venous thrombosis, arterial thrombosis, pregnancy morbidity, recurrent early pregnancy loss, fetal death, cardiovascular risk
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Pregnancy, Pregnancy Complications, Thrombosis, Cohort Studies, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Venous Thrombosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
