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

Guttmann, Allison; Denvir, Brendan; Aringer, Martin; Buyon, Jill P.; Belmont, H. Michael; Sahl, Sara; Salmon, Jane E.; Askanase, Anca; Bathon, Joan M.; Geraldino‐Pardilla, Laura; Ali, Yousaf; Ginzler, Ellen M.; Putterman, Chaim; Gordon, Caroline; Helmick, Charles G.; Parton, Hilary; Izmirly, Peter

doi:10.1002/acr.24960

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…In clinical practice, it is sometimes difficult to differentiate SLE and Sjögren's disease due to common clinical and serological features. 28 Assan et al 29 reported that 2019 EULAR/ACR criteria were met in only 4.2% of Sjögren's disease patients and they claimed that 2019 EULAR/ACR criteria were able to discriminate these two diseases in clinical practice, which was not entirely supported by our observations.…”

Section: Discussioncontrasting

confidence: 72%

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Performances of different classification criteria for systemic lupus erythematosus in a single-center cohort from Turkey

Torun

Bektaş

Kemik

et al. 2022

Lupus

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Objective Sensitivity and specificity of SLE classification criteria may vary in different populations and clinical settings. In this study, we aimed to compare the performances of three criteria sets/rules (1997, 2012, and 2019) in a large cohort of patients and relevant diseased controls. Methods The medical records of consecutive SLE patients and diseased controls were reviewed for clinical and laboratory features relevant to all sets of criteria. Criteria sets/rules were analyzed based on sensitivity, positive predictive value, specificity, and negative predictive value, using clinical diagnosis with at least 6 months of follow-up as the gold standard. A subgroup analysis was performed in ANA positive patients. Results A total of 393 SLE patients and 308 non-SLE diseased controls were included. Sensitivity was 78.4% for 1997 criteria and was more than 90% for both 2012 (91.9%) and 2019 (94.4%) criteria. Specificity was the highest (95.1%) for 1997 ACR criteria, 91.5% for 2012 SLICC criteria and 91.2% for 2019 EULAR/ACR criteria. When only ANA positive patients were analyzed, sensitivity of each criteria increased by 1%, 0.8%, and 2.2%, respectively. Specificity of 1997 criteria decreased by 2% and specificity of 2012 and 2019 criteria both decreased to less than 90%. Conclusion EULAR/ACR criteria were more sensitive than 1997 criteria and had a comparable performance with SLICC criteria. When only ANA positive patients were analyzed, the presence of false positive results (originated from patients with Sjögren’s disease and antiphospholipid syndrome mainly) decreased the specificity of both SLICC and EULAR/ACR criteria.

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Section: Discussioncontrasting

confidence: 72%

“…35 patients (2.3%) fulfilled only 1997 ACR criteria. 28 When we analyzed the twelve patients that failed to meet both recent criteria, we found that two of these patients could be classified as SLE by 1997 ACR criteria. The remaining 10 patients did not meet any of the three criteria.…”

Section: Discussionmentioning

confidence: 99%

Performances of different classification criteria for systemic lupus erythematosus in a single-center cohort from Turkey

Torun

Bektaş

Kemik

et al. 2022

Lupus

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“…SLE was defined as meeting at least one of the following: 1) 1997 American College of Rheumatology (ACR) ( 44 ), Systemic Lupus Erythematosus Collaborating Clinics (SLICC) ( 45 ), or 2019 European League Against Rheumatism (EULAR)/ACR classification criteria ( 46 ) as we previously described ( 47 ). Concomitant rheumatic diseases were defined using modified criteria based on available data collected in the MLSP: SjD (anti-SSA/Ro positive and evidence of keratoconjunctivitis sicca and/or xerostomia, which was our restrictive definition in the primary SjD analysis) ( 40 ), and APLS (antiphospholipid antibody positive and evidence of an arterial or venous clot).…”

Section: Methodsmentioning

confidence: 99%

Prevalence of concomitant rheumatologic diseases and autoantibody specificities among racial and ethnic groups in SLE patients

Denvir,

Carlucci,

Corbitt

et al. 2024

Front. Epidemiol.

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ObjectiveLeveraging the Manhattan Lupus Surveillance Program (MLSP), a population-based registry of cases of systemic lupus erythematosus (SLE) and related diseases, we investigated the proportion of SLE with concomitant rheumatic diseases, including Sjögren’s disease (SjD), antiphospholipid syndrome (APLS), and fibromyalgia (FM), as well as the prevalence of autoantibodies in SLE by sex and race/ethnicity.MethodsPrevalent SLE cases fulfilled one of three sets of classification criteria. Additional rheumatic diseases were defined using modified criteria based on data available in the MLSP: SjD (anti-SSA/Ro positive and evidence of keratoconjunctivitis sicca and/or xerostomia), APLS (antiphospholipid antibody positive and evidence of a blood clot), and FM (diagnosis in the chart).Results1,342 patients fulfilled SLE classification criteria. Of these, SjD was identified in 147 (11.0%, 95% CI 9.2–12.7%) patients with women and non-Latino Asian patients being the most highly represented. APLS was diagnosed in 119 (8.9%, 95% CI 7.3–10.5%) patients with the highest frequency in Latino patients. FM was present in 120 (8.9%, 95% CI 7.3–10.5) patients with non-Latino White and Latino patients having the highest frequency. Anti-dsDNA antibodies were most prevalent in non-Latino Asian, Black, and Latino patients while anti-Sm antibodies showed the highest proportion in non-Latino Black and Asian patients. Anti-SSA/Ro and anti-SSB/La antibodies were most prevalent in non-Latino Asian patients and least prevalent in non-Latino White patients. Men were more likely to be anti-Sm positive.ConclusionData from the MLSP revealed differences among patients classified as SLE in the prevalence of concomitant rheumatic diseases and autoantibody profiles by sex and race/ethnicity underscoring comorbidities associated with SLE.

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Sensitivity of classification criteria from time of diagnosis in an incident systemic lupus erythematosus cohort: a population-based study from Norway

Haukeland,

Moe,

Brunborg

et al. 2024

RMD Open

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ObjectivesTo compare the sensitivity of 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) classification criteria against 1997 ACR criteria for systemic lupus erythematosus (SLE), for incident SLE cases in the presumably complete population-based Nor-SLE cohort from Southeast Norway (2.9 million inhabitants).MethodsAll cases International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coded as SLE during 2000–2017 were individually reviewed. Those with a confirmed SLE diagnosis by expert clinical assessment were included in the Nor-SLE cohort. Core clinical data were recorded, and the cases were classified according to 2019 EULAR/ACR and 1997 ACR criteria. Juvenile SLE was defined as <16 years at diagnosis and adult SLE was defined as ≥16 years at diagnosis.ResultsWe included 737 incident SLE cases (701 adults, 36 juveniles). At diagnosis, 2019 EULAR/ACR criteria were more sensitive than 1997 ACR criteria for adults (91.6% vs 77.3%; p<0.001), but not for juveniles (97.2% vs 88.9%). The 2019 EULAR/ACR counts at diagnosis differed by age group and ethnicity, being higher in young cases and those originating from Asia. From time of diagnosis to study end the fulfilment rate of 2019 EULAR/ACR criteria for the adult cohort increased from 92.5% and 86.5% to 94.6% and 91.0%, respectively, for females and males (mean disease duration of 7.5 years).ConclusionShowing 92% criteria fulfilment already at time of SLE diagnosis by 2019 EULAR/ACR criteria versus 77% by 1997 ACR criteria, the results from this population-based study suggest that the 2019 EULAR/ACR criteria will achieve its goal of capturing more early-SLE cases for clinical trials.

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

Cited by 4 publications

References 19 publications

Performances of different classification criteria for systemic lupus erythematosus in a single-center cohort from Turkey

Performances of different classification criteria for systemic lupus erythematosus in a single-center cohort from Turkey

Prevalence of concomitant rheumatologic diseases and autoantibody specificities among racial and ethnic groups in SLE patients

Sensitivity of classification criteria from time of diagnosis in an incident systemic lupus erythematosus cohort: a population-based study from Norway

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