<h4>Objective</h4>To provide an updated systematic review and meta-analysis of the estimated pooled of anti-Annexin A5 antibodies (AnxA5-Abs) and Annexin A5 resistance (A5R) across antiphospholipid syndrome (APS) phenotypes.<h4>Methods</h4>PubMed, EMBASE, and the Cochrane Library were searched from inception to June 2018 and updated in August 2025. This evidence concerns the gene ANXA5 and antiphospholipid syndrome.