Assessment of EULAR/ACR-2019, SLICC-2012 and ACR-1997 Classification Criteria in SLE with Longstanding Disease

Abstract

Background: Different classification criteria for systemic lupus erythematosus (SLE) have been launched over the years. Our aim was to evaluate the performance of the EULAR/ACR-2019, SLICC-2012 and ACR-1997 classification criteria in a cohort of SLE patients with longstanding disease. Methods: Descriptive observational study in 79 patients with established and longstanding SLE. The three classification criteria sets were applied to those patients. Results: Of the 79 patients, 70 were women (88.6%), with a mean age of 51.8 ± 14 years and a mean disease duration of 15.2 ± 11.5 years. The sensitivity of the different criteria were: 51.9%, 87.3% and 86.1% for ACR-1997, SLICC-2012 and EULAR/ACR-2019, respectively. In total, 68 out of 79 patients (53.7%) met all three classification criteria; 11.4% did not meet any classification criteria and were characterized by low SLEDAI (0.6 ± 0.9), low SLICC/ACR Damage Index (0.88 ± 0.56) and fulfilling only skin domains, antiphospholipid antibodies or hypocomplementemia. To fulfill EULAR/ACR-2019 criteria was associated with low complement levels (p < 0.04), high anti-dsDNA levels (p < 0.001), presence of lupus nephritis III-IV (p < 0.05) and arthritis (p < 0.001). Conclusion: The EULAR/ACR-2019 classification criteria showed high sensitivity, similar to SLICC-2012, in SLE patients with longstanding disease. Patients with serological, articular or renal involvement are more likely to fulfill SLICC-2012 or EULAR/ACR-2019 criteria.

Diagnostic accuracy of the European League against rheumatism/American College of Rheumatology-2019 versus the Systemic Lupus International Collaborating Clinics-2012 versus the ACR-1997 classification criteria in adult systemic lupus erythematosus: A systematic review and meta-analysis

“…was not included because of using ACR-1982 classification criteria and/or Fries diagnosis criteria as the criteria to distinguish SLE patients from control group ( 22 ). Another two studies without setting a control group were excluded as well ( 23 , 24 ). Ultimately, 9 articles were included in this meta-analysis, comprising 3 European studies ( 7 , 9 , 13 ), 2 north American studies ( 6 , 12 ) and 4 Asian studies ( 10 , 11 , 14 , 25 ).…”

Evaluation of the EULAR/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus in a Population‐Based Registry

“…Among their cohort of 79 patients, only 7 were found to meet just 1 of the classification criteria, with 4 patients (5.0%) meeting the SLICC criteria alone, 3 patients (4.0%) meeting the EULAR/ACR criteria alone, and none fulfilling only the 1997 ACR definition. Although the sample was small, all 3 patients satisfying only the EULAR/ACR criteria were found to have a positive ANA test result with just 2 additional manifestations (14). This is similar to what was seen in the current analysis, where all patients fulfilling only the EULAR/ACR system met 3 clinical or immunologic features only.…”

“…A smaller study by Magallares et al compared all 3 classification criteria in SLE patients with longstanding disease (14). Among their cohort of 79 patients, only 7 were found to meet just 1 of the classification criteria, with 4 patients (5.0%) meeting the SLICC criteria alone, 3 patients (4.0%) meeting the EULAR/ACR criteria alone, and none fulfilling only the 1997 ACR definition.…”

Potential Benefit of Rituximab in Rhupus Patients From a Single-Center

“…11 Regarding SLE, the profile of our patients, characterized by a longstanding disease with mainly articular pattern, satisfying both SLE sets of criteria or one of them, is in accordance with the findings of a recent study. 12 However, we cannot exclude induction of SLE manifestations by infliximab (n = 2) or etanercept (n = 1) prescribed in first line for 3 patients who had an initial diagnosis of RA before SLE occurrence.…”