Classification performance of the 2023 ACR/EULAR antiphospholipid syndrome criteria: a systematic review and meta-analysis.
Rheumatology (Oxford)Sep 1, 2026
Clinical ResearchRheumatology
Leyre Riancho-Zarrabeitia, José A Riancho
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In 30 seconds
This systematic review and meta-analysis evaluated the classification performance of the 2023 ACR/EULAR criteria for antiphospholipid syndrome (APS) across 24 studies. The findings revealed a pooled sensitivity of 0.74 and a specificity of 0.99, indicating high specificity but variable sensitivity depending on APS phenotype, particularly low in obstetric APS.
Key findings
- Pooled sensitivity of the 2023 ACR/EULAR criteria was 0.74 (95% CI 0.67-0.81).
- Pooled specificity was 0.99 (95% CI 0.98-1.00).
- Sensitivity was notably low in obstetric APS, with a pooled sensitivity of 0.20.
- Thrombotic APS cases showed higher sensitivity at 0.82.
Why it matters
Understanding the classification performance of the 2023 ACR/EULAR criteria is crucial for clinicians in accurately identifying APS patients, particularly given the variability in sensitivity across different APS phenotypes, which may impact diagnosis and management strategies.