Objectives
To contribute towards characterizing SLE patients as defined by the new SLICC classification criteria (ncSLICC) in comparison with patients defined by classic criteria (ACR-97).
Methods
a retrospective study on a large monocentric cohort of well characterized patients with SLE was carried on, estimating the percentage of patients who meet the ncSLICC and comparing patients with probable SLE (<4 criteria ACR97) (pSLE) redefined as SLE with ncSLICC versus those defined by the ACR97 criteria (≥4criteria) (dSLE). We collected and compared the demographic and clinical characteristics, damage index (SDI), severity Katz index (SKI), major organ involvement, hospitalization, mortality and cumulative treatments data.
Results
All pSLE patients of our cohort (N=39), 9.7% of the total (N=403), were included as well as a random sample of 169 controls with dSLE (41.4% of total cohort of dSLE, N=364); 48 patients did not fulfill the criteria of ACR-82, 18.7% (N=9) of them were rescued as SLE by the ACR-97 criteria, reducing pSLE to 39 patients. 100% of the patients whom met the ACR-97 criteria met also ncSLICC, being estimated that 96.5% of our full cohort (N=403) fulfil the ncSLICC. The frequencies of the different criteria are shown in table1 (data no shown in the abstract); 64% (N=25) (95%CI: 0.47-0.78) of the pSLE met the ncSLICC. The pSLE patients who met ncSLICC are milder than patients with dSLE, with SDI of 0.4 (±56) vs. 1.95 (±2.4) (p<0,001) and SKI of 0.8 vs. 3.7 (±2.4) (see table 2 for all other comparisons), although the duration of disease was higher in dSLE. Matching the 25 pSLE patients who meet ncSLICC with 25 dSLE patients and same duration of the disease (1:1), statistical significance remained for SKI difference (0.8±0.65 vs. 3.32±2.63; p<0.001) and major organ involvement [1 (4.2%) vs. 9 (36%) (p=0.010)].
Table 1
Definite SLE (ACR 97)
Probable SLE (ACR97) SLICC criteria +
P value
N=167
N=25
(Wilcoxon or Fisher)
Age
46.64±13.61
46.2±17.02
=0.74435
Age at onset
31.03±13.18
42±17.53
=0.00272
SLE duration (years)
16.6±8.4
5.2±6.3
<0.0001
SKI
3.66±2.44
0.8±0.65
<0.01
SDI
1.95±2.38
0.4±0.65
=0.00015
Nephritis
53 (32.1%)
0 (0%)
=0.00036
Major organ
91 (54.5%)
1 (4.2%)
<0.01
Corticoids (cumulative)
129 (77.7%)
11 (44%)
0.00105
Antimalarials (cumulative)
138 (82.6%)
13 (52%)
0.0013
Corticoids ≥60mg
71 (42.8%)
3 (12%)
0.00351
SKI, severity Katz index; SDI, SLICC/ACR damage index; AFS, antiphospholipid syndrome; Antimal, antimalarials; CE, corticosteroids.
Conclusions
1. The vast majority of definite SLE patients (ACR-97 criteria) also meet the new SLICC group classification criteria.
2. The new SLICC criteria rescues a significant percentage of patients with incomplete (or probable) SLE, while predominantly incorporating less severe patients.
Disclosure of Interest
None declared
DOI
10.1136/annrheumdis-2014-eular.4762
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