2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria

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Citações na Scopus
53
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Dimensions
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
BARBHAIYA, Medha
ZUILY, Stephane
NADEN, Ray
HENDRY, Alison
MANNEVILLE, Florian
AMIGO, Mary-Carmen
AMOURA, Zahir
ANDREOLI, Laura
ARTIM-ESEN, Bahar
Citação
ARTHRITIS & RHEUMATOLOGY, v.75, n.10, p.1687-1702, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective. To 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. Methods. This international multidisciplinary initiative included 4 phases: 1) Phase I, criteria generation by surveys and literature review; 2) Phase II, criteria reduction bymodified 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-basedmulticriteria decision analysis, and threshold identification; and 4) Phase IV, validation using independent adjudicators' consensus as the gold standard. Results. The 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, followedbyadditiveweightedcriteria (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-beta(2)-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%. Conclusion. These 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.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/59197
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC