DeFazio Catherine, Horvath Lara, Morgan Jennifer, Murphy Meaghan B, Shtoyko Ashley N, Phillips Elizabeth M
Department of Pharmacy, Upstate University Hospital, Syracuse, NY, USA.
Wegmans School of Pharmacy, St John Fisher University, Rochester, NY, USA.
Lupus. 2025 Jan;34(1):34-38. doi: 10.1177/09612033241301173. Epub 2024 Nov 14.
To determine the number of patients that met classification for antiphospholipid antibody syndrome (APS) after applying the 2023 American College of Rheumatology and the European Alliance for Associations of Rheumatology (ACR/EULAR) classification criteria, to identify reasons patients did not meet the new criteria, and determine the number of patients who were single, double, or triple positive based on laboratory criteria.
A single center, retrospective chart review of patients with APS on anticoagulation managed by ambulatory care clinical pharmacists. Data collected included patient demographics, type of anticoagulation, and clinical and laboratory criteria for APS as defined by the 2023 ACR/EULAR criteria. Data is presented using descriptive statistics.
A total of 51 patients previously diagnosed with APS were included. There were 42 patients on warfarin (82.3%), 4 patients on direct oral anticoagulants (19%), 3 patients on low molecular weight heparin (5.8%), and 2 patients on fondaparinux (3.9%). Of the 51 patients, 12 (23.5%) met classification criteria, 33 (64.7%) did not meet classification criteria and 6 (11.7%) had insufficient data. Of the 27 patients that did not meet criteria, 13 patients did not meet the laboratory criteria (39.4%), 6 patients did not meet the clinical criteria (18.2%) and 14 patients did not meet both laboratory and clinical criteria (42.4%). Of the 12 patients that met classification criteria, 2 patients were triple positive (16.7%), 3 were double positive (25%), and 7 were single positive (58.3%).
Results from this study indicate that APS continues to be a complex disease state with challenges in diagnosis and classification. Since only a small number of patients in our clinic continued to meet the classification criteria, opportunities for patient re-evaluation of management strategies at our institution could be considered.
应用2023年美国风湿病学会和欧洲风湿病联盟（ACR/EULAR）分类标准，确定符合抗磷脂抗体综合征（APS）分类的患者数量，找出患者不符合新标准的原因，并根据实验室标准确定单阳性、双阳性或三阳性患者的数量。
对由门诊临床药师管理的接受抗凝治疗的APS患者进行单中心回顾性病历审查。收集的数据包括患者人口统计学信息、抗凝类型以及2023年ACR/EULAR标准定义的APS临床和实验室标准。数据采用描述性统计呈现。
共纳入51例先前诊断为APS的患者。42例患者使用华法林（82.3%），4例患者使用直接口服抗凝剂（19%），3例患者使用低分子肝素（5.8%），2例患者使用磺达肝癸钠（3.9%）。51例患者中，12例（23.5%）符合分类标准，33例（64.7%）不符合分类标准，6例（11.7%）数据不足。在27例不符合标准的患者中，13例患者不符合实验室标准（39.4%），6例患者不符合临床标准（18.2%），14例患者既不符合实验室标准也不符合临床标准（42.4%）。在12例符合分类标准的患者中，2例为三阳性（16.7%），3例为双阳性（25%），7例为单阳性（58.3%）。
本研究结果表明，APS仍然是一种复杂的疾病状态，在诊断和分类方面存在挑战。由于我们诊所只有少数患者继续符合分类标准，因此可以考虑在我们机构对患者管理策略进行重新评估的机会。
