Foddai SG et al. [30] showed that approximately half of the patients diagnosed with APS according to the Sydney criteria would not meet the new 2023 ACR/EULAR classification criteria, and Lu Q et al. [31], who examined two Asian cohorts, reported a high specificity but lower sensitivity compared with the Sydney criteria, especially at the expense of the obstetric morbidity and the presence of IgM isotype antibodies. This evidence concerns the gene CD40LG and autoimmune polyendocrinopathy.