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Assessment of the 2006 revised antiphospholipid syndrome classification criteria
  1. Mala S Kaul (mala.kaul{at}duke.edu)
  1. Weill Medical College of Cornell University, United States
    1. Doruk Erkan (erkand{at}hss.edu)
    1. Hospital for Special Surgery, United States
      1. Lisa Sammaritano (sammaritanol{at}hss.edu)
      1. Hospital for Special Surgery, United States
        1. Michael D Lockshin (lockshinm{at}hss.edu)
        1. Hospital for Special Surgery, United States

          Abstract

          Objective: To analyze antiphospholipid antibody (aPL)-positive patients using the 2006 revised Antiphospholipid Syndrome (APS) classification criteria.

          Methods: A descriptive study of 200 aPL-positive patients identified in a local, hospital-based registry, analyzing demographic, clinical, and aPL characteristics. Patients were analyzed for: a) fulfillment of the 1999 original (Sapporo) and 2006 revised APS classification criteria; b) non-criteria aPL features (for all aPL-positive patients, based on the 2006 revised criteria definitions); and c) non-aPL thrombosis risk factors at the time of the clinical events (for APS patients, based on the 2006 revised criteria stratifications).

          Results: One hundred eighty three of the 200 patients had sufficient data for analysis. Thirty-nine (21%) of the 183 patients did not meet the laboratory requirement of the original 1999 criteria. Of 81 APS patients who met the 1999 classification criteria, 47 (58%) also met the 2006 revised criteria. Of 63 asymptomatic (no vascular or pregnancy events) aPL- positive patients who met the laboratory requirement of the 1999 classification criteria, 38 (60%) also met the laboratory requirement of the 2006 revised criteria. More than 50% of the APS patients with vascular events had identifiable non-aPL thrombosis risk factors at the time of clinical events.

          Conclusions: Only 59% of patients meeting the 1999 APS Sapporo classification criteria met the 2006 APS classification criteria. We believe that the revised criteria will have positive implications in APS research by limiting the inclusion of a heterogeneous group of patients and also by providing a risk-stratified approach.

          • Sapporo classification criteria
          • anti B2-glycoprotein-I antibody
          • anticardiolipin antibody
          • antiphospholipid syndrome
          • lupus anticoagulant

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