Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities
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Published:2020-08-14
Issue:10
Volume:79
Page:1333-1339
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ISSN:0003-4967
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Container-title:Annals of the Rheumatic Diseases
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language:en
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Short-container-title:Ann Rheum Dis
Author:
Johnson Sindhu RORCID, Brinks Ralph, Costenbader Karen H, Daikh David, Mosca Marta, Ramsey-Goldman Rosalind, Smolen Josef S, Wofsy David, Boumpas Dimitrios TORCID, Kamen Diane L, Jayne David, Cervera R, Costedoat-Chalumeau NathalieORCID, Diamond Betty, Gladman Dafna DORCID, Hahn Bevra, Hiepe Falk, Jacobsen Søren, Khanna DineshORCID, Lerstrøm Kirsten, Massarotti Elena, McCune Joseph, Ruiz-Irastorza GuillermoORCID, Sanchez-Guerrero Jorge, Schneider Matthias, Urowitz MurrayORCID, Bertsias George, Hoyer Bimba F, Leuchten Nicolai, Tani Chiara, Tedeschi Sara K, Touma Zahi, Schmajuk Gabriela, Anic Branimir, Assan FlorenceORCID, Chan Tak Mao, Clarke Ann Elaine, Crow Mary K, Czirják László, Doria AndreaORCID, Graninger Winfried B, Halda-Kiss Bernadett, Hasni Sarfaraz, Izmirly Peter M, Jung Michelle, Kumánovics Gábor, Mariette Xavier, Padjen Ivan, Pego-Reigosa José M, Romero-Diaz Juanita, Rúa-Figueroa ÍñigoORCID, Seror Raphaèle, Stummvoll Georg H, Tanaka YoshiyaORCID, Tektonidou Maria GORCID, Vasconcelos Carlos, Vital Edward M, Wallace D J, Yavuz SuleORCID, Meroni Pier LuigiORCID, Fritzler Marvin J, Naden Ray, Dörner ThomasORCID, Aringer MartinORCID
Abstract
ObjectivesThe European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 Classification Criteria for systemic lupus erythematosus (SLE) have been validated with high sensitivity and specificity. We evaluated the performance of the new criteria with regard to disease duration, sex and race/ethnicity, and compared its performance against the Systemic Lupus International Collaborating Clinics (SLICC) 2012 and ACR 1982/1997 criteria.MethodsTwenty-one SLE centres from 16 countries submitted SLE cases and mimicking controls to form the validation cohort. The sensitivity and specificity of the EULAR/ACR 2019, SLICC 2012 and ACR 1982/1997 criteria were evaluated.ResultsThe cohort consisted of female (n=1098), male (n=172), Asian (n=118), black (n=68), Hispanic (n=124) and white (n=941) patients; with an SLE duration of 1 to <3 years (n=196) and ≥5 years (n=879). Among patients with 1 to <3 years disease duration, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 81%). The EULAR/ACR criteria performed well in men (sensitivity 93%, specificity 96%) and women (sensitivity 97%, specificity 94%). Among women, the EULAR/ACR criteria had better sensitivity than the ACR criteria (97% vs 83%) and better specificity than the SLICC criteria (94% vs 82%). Among white patients, the EULAR/ACR criteria had better sensitivity than the ACR criteria (95% vs 83%) and better specificity than the SLICC criteria (94% vs 83%). The EULAR/ACR criteria performed well among black patients (sensitivity of 98%, specificity 100%), and had better sensitivity than the ACR criteria among Hispanic patients (100% vs 86%) and Asian patients (97% vs 77%).ConclusionsThe EULAR/ACR 2019 criteria perform well among patients with early disease, men, women, white, black, Hispanic and Asian patients. These criteria have superior sensitivity than the ACR criteria and/or superior specificity than the SLICC criteria across many subgroups.
Funder
American College of Rheumatology Research and Education Foundation National Institute of Arthritis and Musculoskeletal and Skin Diseases European League Against Rheumatism
Subject
General Biochemistry, Genetics and Molecular Biology,Immunology,Immunology and Allergy,Rheumatology
Cited by
33 articles.
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