#6-12E. Navigating the Evolving Criteria and Epidemiology of Antiphospholipid Syndrome (Nat Rev Rheumatol, 2026)

How do evolving classification criteria and variable laboratory testing impact our understanding of antiphospholipid syndrome (APS) epidemiology? This comprehensive review highlights that applying the 2023 ACR/EULAR criteria substantially improves diagnostic specificity but reclassifies nearly half of previously diagnosed patients, narrowing classified cohorts. However, a major limitation in current epidemiological literature is the frequent reliance on single-timepoint testing or administrative coding without verifying persistent antibody positivity after twelve weeks. For clinicians, recognizing these diagnostic shifts is essential for accurately interpreting serological profiles, avoiding misclassification, and optimizing long-term management in thrombotic and obstetric APS.

Citation: El Hasbani G, Schreiber K, Rodríguez-Pintó I, Devreese KMJ, Andrade D, Duarte-García A. Antiphospholipid syndrome: epidemiology and outcomes in the evolving criteria era. Nature Reviews Rheumatology. 2026.

DOI: 10.1038/s41584-026-01438-7

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