Evolution of the Classification Criteria for Antiphospholipid Syndrome: From Hughes Syndrome to ACR/EULAR Criteria

REVIEW
Ina Toska, Ervin Rapushi, Rexhep Shkurti, Anila Mitre

 
For citation: Toska I, Rapushi E, Shkurti R, Mitre A. Evolution of the Classification Criteria for Antiphospholipid Syndrome: From Hughes Syndrome to ACR/EULAR Criteria. International Journal of Biomedicine. 2026;16(1):14-16. doi:10.21103/Article16(1)_RA2
 
Originally published March 5, 2026

Abstract: 

Antiphospholipid syndrome (APS) is an autoimmune disorder defined by thrombotic events or obstetrical morbidity in the presence of persistent antiphospholipid antibodies, such as lupus anticoagulant (LAC), anticardiolipin (aCL), and ß2-glycoprotein I (ß2-GPI). The need for standardized classification criteria has been recognized as essential for diagnosis, patient stratification, research consistency, and comparison of clinical studies since their initial description. The classification criteria for APS have evolved over the years in response to advances in clinical practice and laboratory standardization. First, based on clinical observations, the preliminary Sapporo criteria highlighted an association among thrombosis, pregnancy morbidity, and antiphospholipid antibodies. The Sydney criteria, an international consensus statement, introduced structured clinical and laboratory criteria and incorporated persistence of antiphospholipid antibodies to improve specificity. The recent classification criteria of the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR), published in 2023, introduced a weighted point system across clinical and laboratory domains, with the aim of achieving high specificity for research.

Keywords: 
antiphospholipid syndrome • Sapporo criteria • Sydney criteria • ACR/EULAR criteria
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Received January 1, 2026.
Accepted February 13, 2026.
©2026 International Medical Research and Development Corporation.