Dr. Erkan did note that a clinical criterion should not be counted if an equally or more likely explanation than APS could be the cause. Dr. Erkan proceeded to go through the weighting of each criterion and the way in which a final score can be calculated, and he also discussed that the new criteria have higher specificity but slightly lower sensitivity as compared to the Revised Sapporo criteria.
Advantages of the New Criteria
Several strengths of the new criteria were summarized toward the end of the session. First, it was noted that the clinical and laboratory criteria are carefully defined, thereby improving reliability and precision. Second, more independent domains with differential weighting now exist, allowing for a more nuanced view of the clinical picture. Third, the validation of the criteria has been based on two international cohorts, with both demonstrating high specificity as compared to the Revised Sapporo criteria. Dr. Erkan did admit that the cohorts do not represent all subpopulations of patients and that no definite gold standard exists for validating APS criteria, but even with these limitations, the criteria are likely to still be of great help to researchers.
In Sum
The session was presented extremely well and, although these are draft criteria and still undergoing ACR, EULAR and journal peer review, the talk generated excitement. Indeed, the understanding of APS is ever evolving, and this initiative from ACR and EULAR represents a step in the right direction.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.
