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Researchers call for new antiphospholipid syndrome diagnostic criteria

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A task force has called for updated criteria for the diagnosis and classification of antiphospholipid syndrome, according to a report presented at the European League Against Rheumatism Annual European Congress of Rheumatology.

In the report, task force members wrote that, of 13 physician-researcher members surveyed, 92% reported that new American College of Rheumatology criteria are needed, and 100% responded that current criteria do not adequately sample all domains or manifestations of antiphospholipid syndrome (APS). Situations in which the current criteria conflicted with expert diagnoses were reported by 85% of respondents, and 62% called for additional tests added to the criteria.

Patients with non-criteria manifestations, obstetric findings that do not conform to current criteria in a patient with a positive antiphospholipid antibodies (aPL) test, patients without persistent aPL test but with expert suspicion of the disease and negative-to-low titer aPL tests in symptomatic patients were cited as scenarios in which expert opinion varied from established criteria.

Limitations of the criteria were expressed by the task force, including the lack of inclusion of clinical manifestations and aPL tests, a lack of evidence-based definition of pregnancy morbidity, no defined aPL profiles or comorbidities to establish risk stratification, and an unclear definition of persistence of aPL.

The task force, created under the auspices of the 15th International Congress on aPL (September 2016, Istanbul, Turkey), is reported to be spearheading an effort to prepare new APS classification criteria, according to the report. – by Shirley Pulawski

Reference:

Barbhaiya M, et al. Paper #AB0561. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosures: Barbhaiya reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.