Lupus & antiphospholipid syndrome
Development of clinical manifestations in individuals positive for antiphospholipid antibodies according to the 2023 ACR/EULAR serological domains
Authors' conclusion
The 2023 ACR/EULAR laboratory scoring system lacked prognostic value in individuals positive for aPL.
Study context
- Population
- Patients with positive LA, aCL or anti-β2GPI (confirmed ≥12 weeks apart, except isolated LA), January 2018–March 2024, without 2006 Sydney criteria or clinical domains 1–4 at serological confirmationmedian follow-up 2.84 years
- Participants
- 985 patients
- Exposure
- 2023 ACR/EULAR serological domains and laboratory score as predictors of clinical manifestations in aPL-positive individuals
- Outcome
- Predictive performance of the 2023 ACR/EULAR laboratory score for clinical manifestations (domains 1-4)
Methodological detailsobservational, logistic regression adjusted for potential confounders, ROC curve analyses
- Observational
- Logistic regression adjusted for potential confounders
- ROC curve analyses
Main finding
As reported in the abstract
Prediction of clinical manifestations by the 2023 ACR/EULAR laboratory score
Laboratory score did not predict VTE, ATE, microvascular thrombosis, or obstetric morbidity (overall AUC)
0.535
Cumulative incidence of clinical events
<3%
Observational data: associations, not effects.
Further findings
ATE in low-risk patients: moderate/high IgM aCL/anti-β2GPI
| OR (95% CI) | P value | ||
|---|---|---|---|
| Moderate/high IgM aCL/anti-β2GPI | 2.89 (1.15–7.30) | P = 0.025 | |
| 0.10.31310Odds ratio (log scale) |
Future antiphospholipid syndrome (APS) classification: high-titer IgG aCL/anti-β2GPI
| OR (95% CI) | P value | ||
|---|---|---|---|
| High-titer IgG aCL/anti-β2GPIIndependently linked | 4.73 (1.11–15.52) | P = 0.01 | |
| 0.050.21520Odds ratio (log scale) |
Reduced event-free survival: high-titer IgG aCL/anti-β2GPI
| HR for clinical event (reduced event-free survival) (95% CI) | P value | ||
|---|---|---|---|
| High-titer IgG aCL/anti-β2GPI | 3.27 (1.17–9.16) | P = 0.024 | |
| 0.10.31310HR for clinical event (reduced event-free survival) (log scale) |
Median time to onset of clinical manifestations
Years
- Obstetric morbidity
- 0.68
- Arterial thrombosis (ATE)
- 0.80
- Microvascular events
- 2.29
Original publication
Development of clinical manifestations in individuals positive for antiphospholipid antibodies according to the 2023 ACR/EULAR serological domains. Semin Arthritis Rheum. Published 19 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →