Performance of the proposed ACR–EULAR classification criteria for systemic lupus erythematosus (SLE) in a cohort of patients with SLE with neuropsychiatric symptoms

Gegenava, M; Beaart, H.J.L.; Monahan, Rory C; Brilman, E.G.; Voorde, Liesbeth J J Beaart-van de; Magro-Checa, César; Steup-Beekman, Gerda M

doi:10.1136/rmdopen-2019-000895

Cited by 15 publications

(18 citation statements)

References 10 publications

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“…These criteria, however, need to be validated in several eth nic groups; for example, in 2 multiethnic, multicenter cohorts, one from the US (LUpus in MInorities, NAture versus nurture [LUMINA]) and the other from Latin America (Grupo Latinoamericano de Estudio del Lupus Eritematoso [GLADEL]), we found a sensitiv ity of 84.8% and 91.3%, respectively, using as gold standard the 1982/1997 ACR revised classification criteria for SLE as updated in 1997 (3)(4)(5)(6)(7). Similarly, in Brazil, in a cohort of childhood onset SLE patients, the sensitivity of the EULAR/ACR criteria was 87.7%, and the specificity was 67.4% using as gold standard the clinical criteria (8), while in the Netherlands, the sensitivity was 87.% and the specificity was 74% in a cohort of SLE patients with neuropsychiatric symptoms (9).…”

Section: Introductionmentioning

confidence: 99%

Achievement of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Criteria for Systemic Lupus Erythematosus and Amount of Damage Accrual: Results From a Multiethnic Multicenter Cohort

Ugarte‐Gil

Pons‐Estel

Griffin

et al. 2021

Arthritis Care & Research

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Objective To determine the difference in outcomes in patients who achieved or did not achieve the 2019 European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) criteria. Methods Patients from the LUpus in MInorities, NAture versus nurture (LUMINA) cohort were included. For these analyses, we compared those patients who achieved the 2019 EULAR/ACR criteria any time during follow‐up to those who did not. The predefined outcomes were the last Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) scores and survival. Univariable and multivariable negative binomial regression models were performed; adjustment models were based on a forward selection process. Results In total, 98 of 640 patients never achieved the 2019 EULAR/ACR criteria. There was no difference in mean baseline SDI score among the patients who did not achieve the criteria compared to those who did. Conversely, the mean ± SD SDI score at last visit was lower for those who never achieved the criteria (1.2 ± 1.7 versus 2.0 ± 2.3, P = 0.0004). In the final adjusted model, the SDI score at last visit was 31% lower for those who never achieved the criteria (P = 0.0077). These patients were also more likely to survive, but this was not statistically significant. Conclusion In our cohort, patients who did not achieve the 2019 EULAR/ACR criteria accrued less damage, suggesting that these criteria could allow us to identify a subset of patients with more severe disease than allowed by previous criteria.

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Section: Introductionmentioning

confidence: 99%

Achievement of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Criteria for Systemic Lupus Erythematosus and Amount of Damage Accrual: Results From a Multiethnic Multicenter Cohort

Ugarte‐Gil

Pons‐Estel

Griffin

et al. 2021

Arthritis Care & Research

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“…Previous studies that analyzed the performances of these three classification criteria in different populations have yielded various results. 1,2,8,11,14,[16][17][18][19][20][21][22][23][24][25][26] The sensitivities and specificities varied considerably in these studies. Sensitivities as low as 56% 21 and as high as 100% 14,21,25 and specificities as low as 56.5% 20 and as high as 100% 21,23 have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Studies performed by Batu et al, 14 Rodrigues Fonseca et al, 16 Aljaberi et al, 18 and Ma et al 23 were performed in pediatric SLE patients. Study of Gegenava et al 19 focused on SLE patients that had neuropsychiatric symptoms. Rest of the studies did not define specific SLE subgroups, but they were performed in different populations across the globe.…”

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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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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“…10 Studies have compared the performance of SLICC criteria (sensitivity between 85% and 96.7%; specificity 76% and 83.6%) and ARC-EULAR (sensitivity between 87% and 96.3%; specificity 74% and 93.4%). [11][12][13] Both criteria performed worse in one of the studies, this, according to the authors, being due to a more selected population with several confounding factors. Thus, in more challenging situations, when classification criteria may be more useful, the performance can be sub-optimal.…”

Section: Introductionmentioning

confidence: 95%

<p>Towards Precision Medicine in Systemic Lupus Erythematosus</p>

Lever¹,

Alves²,

Isenberg³

2020

PGPM

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Systemic lupus erythematosus (SLE) is a remarkable condition characterised by diversity amongst its clinical features and immunological abnormalities. In this review, we attempt to capture the major immunological changes linked to the pathophysiology of lupus and discuss the challenge it presents in moving towards the concept of precision medicine. Currently broadly similar types of drugs, e.g., steroids, immunosuppressives, hydroxychloroquine are used to treat many of the diverse clinical features of SLE. We suspect that, as the precise immunopathological abnormalities differ between the various organs/systems in lupus patients, it will be some time before precision medicine can be fully applied to SLE.

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Performance of the proposed ACR–EULAR classification criteria for systemic lupus erythematosus (SLE) in a cohort of patients with SLE with neuropsychiatric symptoms

Cited by 15 publications

References 10 publications

Achievement of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Criteria for Systemic Lupus Erythematosus and Amount of Damage Accrual: Results From a Multiethnic Multicenter Cohort

Achievement of the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology Criteria for Systemic Lupus Erythematosus and Amount of Damage Accrual: Results From a Multiethnic Multicenter Cohort

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

<p>Towards Precision Medicine in Systemic Lupus Erythematosus</p>

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