{
  "abstract": "Objectives The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS), launched within the European APS Forum in 2012, has progressively incorporated data from more than 30 tertiary hospitals, including complete, non-criteria and incomplete phenotypes. Recent analyses from EUROAPS have revealed substantial limitations of current APS classification frameworks when applied to obstetric disease, with a large proportion of clinically relevant cases remaining unclassified. The objective of this study is to present EUROAPS-NEXT, a next-generation European obstetric aPL network designed to integrate past experience with future diagnostic and research needs.Methods EUROAPS-NEXT is conceived as a hybrid registry combining prospective enrolment with the progressive retrospective incorporation of historical EUROAPS cases, ensuring longitudinal continuity and data traceability. The registry structure has been simplified to facilitate participation while preserving essential clinical, obstetric and immunological variables. In addition to benchmarking patients against contemporary APS classification criteria, EUROAPS-NEXT captures a broad spectrum of obstetric manifestations, including recurrent pregnancy loss, placental-mediated complications, implantation failure and non-criteria presentations. Detailed antiphospholipid antibody profiling (isotype, persistence, titre and combinations), pregnancy management strategies and outcomes are recorded using a shared electronic platform designed to be reproducible, auditable and adaptable.Results The EUROAPS framework currently includes approximately 1,200 women fulfilling classical definitions of OAPS and more than 800 women with incomplete or non-criteria obstetric APS phenotypes. When applying the 2023 ACR/EULAR classification criteria to the cohort of 1,200 complete OAPS cases, 816 cases (68%) were excluded due to insufficient clinical points, predominantly within the obstetric morbidity domain. Early and mid-gestational pregnancy losses, weighted as low-score and non-cumulative events, accounted for most exclusions, leaving placental-mediated complications as the only obstetric manifestations consistently meeting classification thresholds. Additional exclusions were related to laboratory criteria, including the limited weight assigned to persistent IgM isotypes and the use of fixed ELISA cut-offs.Conclusions EUROAPS-NEXT represents an evolution of a long-standing European collaborative effort, aiming to safeguard obstetric and reproductive APS from under-recognition. By combining historical data, prospective enrolment and flexible phenotypic modelling, this initiative seeks to support clinically meaningful research and contribute to the future development of diagnostic criteria that better reflect real-world obstetric APS.",
  "authors": [
    {
      "affiliations": [
        "Department of Internal Medicine, CSAPG. Systemic Autoimmune Research Unit, Vall d Hebron Research Institut, Barcelona, Spain"
      ],
      "name": "Enrique Esteve Valverde"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, Thrombotic and Hemorrhagic Center, Department of Medicine-DIMED, University of Padua, Padua, Italy"
      ],
      "name": "Ariela Hoxha"
    },
    {
      "affiliations": [
        "Systemic Autoimmune Research Unit, Vall d Hebron Research Institut., Barcelona, Spain"
      ],
      "name": "Ariadna Anunciación Llunell"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Saint-Antoine University Hospital, Paris, France"
      ],
      "name": "Arsène Mekinian"
    },
    {
      "affiliations": [
        "Department of Clinical and Experimental Sciences, Rheumatology and Clinical Immunology, University of Brescia, Brescia, Italy"
      ],
      "name": "Angela Tincani"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Institut d’Investigació Biomèdica Sant Pau-IIB Sant Pau, HSCSP, Barcelona, Spain"
      ],
      "name": "Cristina Trilla"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Department Clinique of L’Anjou, Angers, France"
      ],
      "name": "Cristina Belizna"
    },
    {
      "affiliations": [
        "Obstetrics and Gynaecology Department, Hospital Quirón, Barcelona, Spain"
      ],
      "name": "Raquel Ferrer Oliveras"
    },
    {
      "affiliations": [
        "Autoimmune, Thrombophilic Diseases and Pregnancy Section, Acute Hospital Dr Carlos G. Durand, Buenos Aires, Argentina"
      ],
      "name": "Sebastian Udry"
    },
    {
      "affiliations": [
        "Department of Autoimmune Diseases, Member of the European Reference Centres (ERN) Re-CONNET and RITA, Hospital Clínic, Barcelona, Spain"
      ],
      "name": "Ricard Cervera"
    },
    {
      "affiliations": [
        "Department of Medicine. UAB. Systemic Autoimmune Research Unit, Vall d Hebron Research Institute, Barcelona, Spain"
      ],
      "name": "Jaume Alijotas Reig"
    }
  ],
  "title": "LBA:01:02 EUROAPS-NEXT: a next-generation European obstetric aPL network for obstetric APS research in the new era",
  "uid": "e1c5a35f-3a69-5591-9d48-469472a8a046"
}