OC 16.5 - 2023 ACR/EULAR classification criteria in existing research cohorts: a multicenter collaboration

Sunday, June 23, 2024

10:30 – 10:45 ICT

Room: 111 A-C

Presenting Author(s)

Irene Cecchi, MD,PhD

Researcher
University of Turin
Turin, Piemonte, Italy

Co-Author(s)

Massimo Radin, MD

Researcher
University of Turin
Turin, Piemonte, Italy
SF

Silvia Grazietta Foddai

PhD-Student
University of Turin
Turin, Piemonte, Italy
ER

Elena Rubini

MD
University of Turin
Turin, Piemonte, Italy
Alice Barinotti, MSc

PhD-Student
University of Turin
Turin, Piemonte, Italy
PA

Paula Alba

Professor
University of Cordoba
Cordoba, Cordoba, Argentina
CG

Carmen Gilmen Alonso

MD
University of Cordoba
Cordoba, Cordoba, Argentina
DR

Daniela Rossi

MD
University of Turin
Turin, Piemonte, Italy
DR

Dario Roccatello

Professor
University of Turin
Turin, Piemonte, Italy
SS

Savino Sciascia

Physician
University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-ReConnect and RITA-ERN Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Department of Clinical and Biological Sciences, ASL Città Di Torino and University of Turin, Turin, Italy
Turin, Piemonte, Italy

Background: The newly released APS classification criteria (ACR/EULAR 2023) have the potential to represent a step forward in understanding this complex disease and they might have important implications for patients’ management and treatment.

Aims: Assessing the impact of the updated ACR/EULAR APS classification criteria to our research cohort.

Methods: Consecutive patients who tested persistently positive for at least one aPL in the last three years were enrolled. The first APS Sydney index event was considered and computed for the comparison between Sydney and 2023 APS criteria. When computing the 2023 APS criteria, additional manifestations were also considered.

Results: The cohort comprised 249 patients (185 with APS and 64 aPL carriers according to Sydney criteria). The 185 patients had as first index event VT in 55 cases (29.8%) AT in 63 (34%) and PM in 67 (36.2%).When applying the updated criteria, 90 subjects (48.7%) failed to reach the composite score of the new criteria. The percentage of thrombotic APS per Sydney criteria decreased from 47.3% to 34.9% because of high cardiovascular risk in 23 cases, IgM aPL profile in 6 cases and in 2 patients for both reasons. Patients with PM decreased from 26.9 to 3.2% (39 cases of recurrent early pregnancy loss and 20 of foetal losses). Consequently, the percentage of aPL carriers increased from 26% to 61%. When looking at the disease evolution at follow-up, 32 additional patients out of 90 (35.6%) fulfilled the new APS criteria, after developing additional clinical manifestation following index event.

Conclusion(s): When applying the new APS criteria to our research cohort, not negligible differences exist in patients’ classification. A multidisciplinary approach will be mandatory to assess the impact into research and, ultimately, patient’s care of new criteria.