Impact of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus in a Multicenter Cohort Study of 133 Women With Undifferentiated Connective Tissue Disease

Radin, Massimo; Schreiber, Karen; Cecchi, Irene; Bortoluzzi, Alessandra; Crisafulli, Francesca; Freitas, Cristiano M. de; Bacco, Beatrice; Rubini, Elena; Foddai, Silvia Grazietta; Padovan, Melissa; Cassarino, Silvia Gallo; Franceschini, Franco; Andrade, Danieli; Benedetto, Chiara; Govoni, Marcello; Bertero, Tiziana; Marozio, Luca; Roccatello, Dario; Andréoli, Laura; Sciascia, Savino

doi:10.1002/acr.24391

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…For example, a patient with positive ANA antibodies, who presents with arthritis and thrombocytopenia, would fulfill the 2019 EULAR/ACR classification criteria but not the 2012 SLICC criteria. Similar results were reported by Radin et al [ 17 ], who retrospectively applied the 2019 SLE classification criteria to 133 female patients with UCTD and found that 22 patients (17%) fulfilled them. Early identification of SLE in patients with a previous diagnosis of UCTD might be important not only from a scientific point of view, but it could also influence the management of these patients, leading to closer follow-up, access to specific treatments (e.g., belimumab, rituximab, or anifrolumab), or eligibility to enter clinical trials [ 17 ].…”

Section: Discussionsupporting

confidence: 88%

“…Similar results were reported by Radin et al [ 17 ], who retrospectively applied the 2019 SLE classification criteria to 133 female patients with UCTD and found that 22 patients (17%) fulfilled them. Early identification of SLE in patients with a previous diagnosis of UCTD might be important not only from a scientific point of view, but it could also influence the management of these patients, leading to closer follow-up, access to specific treatments (e.g., belimumab, rituximab, or anifrolumab), or eligibility to enter clinical trials [ 17 ]. It also underlines the need for tailored classification criteria or management guidelines for UCTD, which do not exist hitherto [ 17 ].…”

Section: Discussionsupporting

confidence: 88%

“…Early identification of SLE in patients with a previous diagnosis of UCTD might be important not only from a scientific point of view, but it could also influence the management of these patients, leading to closer follow-up, access to specific treatments (e.g., belimumab, rituximab, or anifrolumab), or eligibility to enter clinical trials [ 17 ]. It also underlines the need for tailored classification criteria or management guidelines for UCTD, which do not exist hitherto [ 17 ]. In addition, when retrospectively applying the 2019 SLE classification criteria to 214 antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients, Kwon et al [ 18 ] found that 51 of them had positive ANA and 10 patients fulfilled the SLE criteria, the key indicator for differentiating AAV from SLE with histological confirmation.…”

Section: Discussionmentioning

confidence: 99%

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Performance of the New 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria in a Large Unicentric Cohort

et al. 2022

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Background: The recently published 2019 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) classification criteria for systemic lupus erythematosus (SLE) were developed to increase the reliability and identification of SLE, especially in early disease. With the emergence of several new drugs for SLE, identifying and treating patients early are more important than ever. Methods: Data of 446 SLE patients evaluated in our center between 1996–2019 and 226 controls with other autoimmune diseases evaluated between 2001–2022 were retrospectively analyzed. The sensitivity and specificity of the 2019 ACR/EULAR criteria were compared to the 2012 SLICC and the 1997 ACR criteria. Results: The 2019 ACR/EULAR criteria showed very good sensitivity (86.6%) compared to the 1997 ACR criteria (76.7%), p < 0.001, with a trend toward significance compared to the 2012 SLICC criteria (83.6%), p = 0.072. Their sensitivity remained high (87.6%) in patients with a short disease duration. The specificity of the 2019 ACR/EULAR criteria (91.2%) was statistically lower than the 2012 SLICC (96.0%) and 1997 ACR criteria (95.1%), p = 0.007 and p = 0.012, respectively, but still had a very high value. A total of 22 controls (9.7%) fulfilled at least one set of criteria (15 patients with MCTD, 5 with UCTD, and 2 with SSc). Conclusion: In this large real-life cohort, the 2019 ACR/EULAR criteria had very good performance compared to the 2012 SLICC and 1997 ACR criteria.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Performance of the New 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria in a Large Unicentric Cohort

et al. 2022

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“…Radin et al found in a multicenter European cohort of 133 women with UCTD that 21 (17%) could be reclassified as SLE when applying the EULAR/ACR criteria. 101 While, Drehmel et al studied 129 patients from a single USA center, the Nebraska Medical Center, and showed similar results with 26 patients (20.2%) being reclassified as SLE. 102…”

Section: Impact Of Applying the 2019 Eular/acr Sle Classification Cri...mentioning

confidence: 89%

The Rise and Rise of Lupus

González

Ugarte‐Gil

Pons-Estel

et al. 2023

Lupus

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Despite how difficult the early diagnosis of systemic lupus erythematosus (SLE) is, which is mainly due to the heterogeneity and non-specificity of its clinical manifestations, SLE is currently being diagnosed more frequently than in past decades. In fact, there has been an increase in the incidence and prevalence of SLE over the last four decades; this can be explained by a number of reasons including a better knowledge of the pathogenesis of the disease which allows its earlier diagnosis, the rising ethnic and racial diversity of the world population, the use of the 2019 EULAR/ACR criteria that allows classifying patients earlier, and improvements in survival over the last decades, which results in an increase in the prevalent cases of SLE. In this article, we will also review the genetic, environmental, and lifestyle factors, that are reported to increase the risk of developing SLE and how preventive strategies through a clinical care pathway may prevent or delay the development of SLE and improve these patients’ outcomes.

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“…However, in the EULAR/ACR criteria, a general attribution rule has been de ned as counting an item in favor of SLE only if SLE is the most likely explanation, so all clinical and immunologic manifestations should be considered comprehensively. The study of Radin et al [21] included 133 patients with UCTD, of whom 22 (17%) cases ful lled the EULAR/ACR-2019 criteria. In another study, when applying the SLICC-2012 and EULAR/ACR criteria, 18 (14.0%) and 26 (20.2%) patients with UCTD were reclassi ed as SLE [22].…”

Section: Discussionmentioning

confidence: 99%

Performance of 2019 EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus in Children and Adults : A Retrospective Observational Study

Cheng

Ding

Xue

et al. 2021

Preprint

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Background: The European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) recently developed a systemic lupus erythematosus (SLE) classification criteria (EULAR/ACR-2019) with high sensitivity and specificity. The aim of this study was to validate and compare the performance of the newly developed criteria to that of the ACR-1997 and the 2012 Systemic Lupus International Collaborating Clinics (SLICC-2012) criteria in juvenile-onset SLE (jSLE) and adult-onset SLE (aSLE) patients.Methods: We conducted a retrospective study of SLE patients (221 children and adult) and controls (214 children and adult) with defined rheumatic diseases to establish the ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria. The performance of the three criteria was statistically analyzed.Results: For jSLE, sensitivities of ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria were 63.3%, 94.6% and 98.2% (P < 0.001), with specificities 99.5%, 98.6% and 93.5% (P < 0.001), respectively. For aSLE, sensitivities of ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria were 72.9%, 96.8% and 99.1% (P < 0.001), with specificities 97.2%, 92.5% and 90.2% (P = 0.013), respectively. In ANA positive juvenile patients, a EULAR/ACR score ≥13 instead of a score ≥10 resulted in higher specificity (93.1% vs. 75.9%), despite slightly lower sensitivity (92.2% vs. 99.5%). In both jSLE and aSLE patients, the SLICC-2012 and EULAR/ACR-2019 criteria had increased sensitivity for major organ involvement than ACR-1997.Conclusion: The EULAR/ACR-2019 criteria showed similar sensitivity to jSLE and aSLE patients and was more sensitive than ACR-1997 and SLICC-2012 criteria, allowing earlier recognition of patients with single or major organ involvement. The adoption of a EULAR/ACR total score ≥13 in this study, instead of the initially proposed ≥10 score, was more appropriate to classify jSLE.

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Impact of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus in a Multicenter Cohort Study of 133 Women With Undifferentiated Connective Tissue Disease

Cited by 10 publications

References 14 publications

Performance of the New 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria in a Large Unicentric Cohort

Performance of the New 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Systemic Lupus Erythematosus Classification Criteria in a Large Unicentric Cohort

The Rise and Rise of Lupus

Performance of 2019 EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus in Children and Adults : A Retrospective Observational Study

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