16th International congress on antiphospholipid antibodies task force report on clinical manifestations of antiphospholipid syndrome

Sciascia, Savino; Radin, Massimo; Cecchi, Irene; Levy, Roger A.; Erkan, Doruk

doi:10.1177/09612033211020361

Cited by 12 publications

(6 citation statements)

References 37 publications

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“…Since the introduction of the Sapporo criteria, advancements in our understanding of APS include better characterization of aPL-associated nonthrombotic clinical manifestations, identification of the role of traditional thrombosis risk factors in aPL-positive individuals, and risk stratification by aPL profile (3,4). Furthermore, the revised Sapporo criteria have been criticized for not incorporating evidence-based definitions, e.g., aPL positivity, microvascular disease, or pregnancy morbidity, resulting in the inclusion of a heterogeneous group of "aPL-positive" patients with different risk profiles for research (4,5). More stringent methodology, using data-driven and expert-based approaches to develop robust classification criteria in rheumatic diseases, is now available (6).…”

Section: Introductionmentioning

confidence: 99%

The 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria

Barbhaiya,

Zuily,

Naden

et al. 2023

Arthritis & Rheumatology

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108

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ObjectiveTo develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR.MethodsThis international multidisciplinary initiative included 4 phases: 1) Phase I, criteria generation by surveys and literature review; 2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; 3) Phase III, criteria definition, further reduction with the guidance of real‐world patient scenarios, and weighting via consensus‐based multicriteria decision analysis, and threshold identification; and 4) Phase IV, validation using independent adjudicators’ consensus as the gold standard.ResultsThe 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL‐associated clinical criterion, followed by additive weighted criteria (score range 1–7 points each) clustered into 6 clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and 2 laboratory domains (lupus anticoagulant functional coagulation assays, and solid‐phase enzyme‐linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti–β2‐glycoprotein I antibodies). Patients accumulating at least 3 points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria versus the 2006 revised Sapporo classification criteria had a specificity of 99% versus 86%, and a sensitivity of 84% versus 99%.ConclusionThese new ACR/EULAR APS classification criteria were developed using rigorous methodology with multidisciplinary international input. Hierarchically clustered, weighted, and risk‐stratified criteria reflect the current thinking about APS, providing high specificity and a strong foundation for future APS research.

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Section: Introductionmentioning

confidence: 99%

The 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria

Barbhaiya,

Zuily,

Naden

et al. 2023

Arthritis & Rheumatology

Self Cite

108

View full text Add to dashboard Cite

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“…However, the Sydney APS criteria were designed to guide research classification and not for clinical purposes. 18 , 19 The threshold for positivity (>40 IgG phospholipid or IgM phospholipid units) is based on data available in 2006, and there is no definition available to distinguish moderate-high from low antibody titers. 18 , 20 Since 2006, several clinical features not present in the original or revised criteria have been recognized as strongly associated with APS.…”

Section: Discussionmentioning

confidence: 99%

Digital ulcers as presenting symptom of secondary antiphospholipid syndrome

Cravero¹,

Maddy²,

Motaparthi³

2022

JAAD Case Reports

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“…However, the identification of HFpEF may help to refine the heterogenous clinical phenotypes of APS patients [39,40], potentially identifying those at higher risk of cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Antiphospholipid Antibodies and Heart Failure with Preserved Ejection Fraction. The Multicenter ATHERO-APS Study

Pastori

Triggiani

Ciampa

et al. 2021

JCM

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Background. The prevalence of heart failure with preserved ejection fraction (HFpEF) in patients with antiphospholipid syndrome (APS) is unknown. Methods. A prospective multicenter cohort study including 125 patients was conducted: 91 primary APS (PAPS), 18 APS-SLE, and 16 carriers. HFpEF was diagnosed according to the 2019 European Society of Cardiology criteria: patients with ≥5 points among major and minor functional and morphological criteria including NT-ProBNP > 220 pg/mL, left atrial (LA) enlargement, increased left ventricular filling pressure. Results. Overall, 18 (14.4%) patients were diagnosed with HFpEF; this prevalence increased from 6.3% in carriers to 13.2% in PAPS and 27.8% in APS-SLE. Patients with HFpEF were older and with a higher prevalence of hypertension and previous arterial events. At logistic regression analysis, age, arterial hypertension, anticardiolipin antibodies IgG > 40 GPL (odds ratio (OR) 3.43, 95% confidence interval (CI) 1.09–10.77, p = 0.035), anti β-2-glycoprotein-I IgG > 40 GPL (OR 5.28, 1.53–18.27, p = 0.009), lupus anticoagulants DRVVT > 1.25 (OR 5.20, 95% CI 1.10–24.68, p = 0.038), and triple positivity (OR 3.56, 95% CI 1.11–11.47, p = 0.033) were associated with HFpEF after adjustment for age and sex. By multivariate analysis, hypertension (OR 19.49, 95% CI 2.21–171.94, p = 0.008), age (OR 1.07, 95% CI 1.00–1.14, p = 0.044), and aβ2GPI IgG > 40 GPL (OR 8.62, 95% CI 1.23–60.44, p = 0.030) were associated with HFpEF. Conclusion. HFpEF is detectable in a relevant proportion of APS patients. The role of aPL in the pathogenesis and prognosis of HFpEF needs further investigation.

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16th International congress on antiphospholipid antibodies task force report on clinical manifestations of antiphospholipid syndrome

Cited by 12 publications

References 37 publications

The 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria

The 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria

Digital ulcers as presenting symptom of secondary antiphospholipid syndrome

Antiphospholipid Antibodies and Heart Failure with Preserved Ejection Fraction. The Multicenter ATHERO-APS Study

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