[Updates on antiphospholipid syndrome]

Antiphospholipid syndrome (APS) is characterized by recurrent arteriovenous thrombosis and pregnancy complications associated with persistent antiphospholipid antibodies (aPL). The 2023 ACR/EULAR classification criteria introduced a scoring system incorporating microvascular disease, cardiac valve disease, and thrombocytopenia. However, these criteria are designed for research classification rather than clinical diagnosis. In laboratory testing, the expanding use of automated immunoassays necessitates inter-assay standardization. Risk stratification integrates quantitative aPL assessment, including triple positivity, aPL score, and Global APS Score (GAPSS), with conventional cardiovascular risk factors. For thrombotic APS, direct oral anticoagulants should be avoided in high-risk patients. Disease activity assessment has advanced with the development of EAPSDAS and the monocyte-to-HDL cholesterol ratio. These advances are expected to facilitate a paradigm shift toward precision medicine in APS management.