The following is a summary of “Performance of the 2023 American College of Rheumatology/EULAR Classification Criteria for Antiphospholipid Syndrome in a Mexican Cohort,” published in the July 2024 issue of Rheumatology by Cimé-Aké et al.

Researchers conducted a retrospective study evaluating the effectiveness of the 2023 American College of Rheumatology/EULAR classification criteria (2023 AECC) for antiphospholipid syndrome (APS) in a Mexican cohort.

In the study, they enrolled patients with primary APS (PAPS) and secondary APS (SAPS), along with a group of individuals with non-autoimmune thrombophilia. Adherence to the 2023 AECC and the 2006 Revised Sapporo Classification Criteria (2006 RSCC) was assessed, and the criteria’s performance was compared against the clinical diagnosis, considered the gold standard. The baseline Global APS Score (GAPSS) and the Damage Index for APS (DIAPS) were also calculated at the final follow-up.

The result showed 85 patients with PAPS, 54 with SAPS, and 50 with thrombophilia. Using the 2023 AECC criteria, 69 patients with PAPS (81.2%) and 28 patients with SAPS (51.9%) met the criteria, while none with thrombophilia did. Among patients with PAPS, true positives (TP) (n=69) showed more frequent thrombotic events and higher positivity for IgM anti-cardiolipin and IgG anti-β2-glycoprotein-I compared to false negatives (FN) (n=16). The 2023 AECC score correlated with both GAPSS (rho=0.621, P<0.0001) and DIAPS (rho=0.433, P<0.0001) for PAPS. Compared to the 2006 RSCC, the 2023 AECC had lower sensitivity (81.2% vs. 88.2%) but higher specificity (100.0% vs. 92.0%) in PAPS, with similar results in SAPS.

Investigators concluded that the 2023 AECC criteria, with greater specificity than the 2006 RSCC, effectively identify patients with PAPS and SAPS at higher risk of thrombosis and damage accumulation.

Source: acrjournals.onlinelibrary.wiley.com/doi/abs/10.1002/art.42957