Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities.


Journal

Annals of the rheumatic diseases
ISSN: 1468-2060
Titre abrégé: Ann Rheum Dis
Pays: England
ID NLM: 0372355

Informations de publication

Date de publication:
10 2020
Historique:
received: 19 03 2020
revised: 17 06 2020
accepted: 18 06 2020
pubmed: 21 8 2020
medline: 24 11 2020
entrez: 21 8 2020
Statut: ppublish

Résumé

The 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. Twenty-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. The 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%). The 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.

Identifiants

pubmed: 32816709
pii: annrheumdis-2020-217162
doi: 10.1136/annrheumdis-2020-217162
doi:

Types de publication

Journal Article Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1333-1339

Subventions

Organisme : Department of Health
ID : CS-2013-13-032
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M01665X/1
Pays : United Kingdom
Organisme : MRF
ID : MRF_MRF-159-0003-ELP-VITAL
Pays : United Kingdom
Organisme : Department of Health
ID : RTF/01/097
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Sindhu R Johnson (SR)

Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital; Institute of Health Policy, Management and Evaulation, University of Toronto, Toronto, Ontario, Canada Sindhu.Johnson@uhn.ca martin.aringer@uniklinikum-dresden.de.

Ralph Brinks (R)

Policlinic and Hiller Research Unit of Rheumatology, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany.

Karen H Costenbader (KH)

Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Rheumatology, Harvard Medical School, Boston, Massachusetts, USA.

David Daikh (D)

Medicine/Rheumatology, UCSF Medical Center, San Francisco, California, USA.

Marta Mosca (M)

Rheumatology Unit, University of Pisa, Pisa, Italy.

Rosalind Ramsey-Goldman (R)

Medicine/Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Josef S Smolen (JS)

Rheumatology, Medical University of Vienna, Vienna, Austria.

David Wofsy (D)

Division of Rheumatology, , Russell/Engleman Rheumatology Research Center, University of California, San Francisco, San Francisco, California, USA.

Dimitrios T Boumpas (DT)

Medicine, National and Kapodestrian University of Athens, and Biomedical Research Foundation of the Athens Academy, Athens, Greece.
Rheumatology, University of Cyprus Medical School, Nicosia, Nicosia, Cyprus.

Diane L Kamen (DL)

Rheumatology, Medical University of South Carolina, Charleston, South Carolina, USA.

David Jayne (D)

Medicine, University of Cambridge, Cambridge, UK.

R Cervera (R)

Autoimmune Diseases, Hospital Clinic, University of Barcelona, Barcelona, Catalonia, Spain.

Nathalie Costedoat-Chalumeau (N)

Internal Medicine, Hospital Cochin, Paris, Île-de-France, France.
INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité, Université Paris Descartes-Sorbonne Paris Cité, Paris, France.

Betty Diamond (B)

Autoimmune and Musculoskeletal, Feinstein Institutes for Medical Research, Manhasset, New York, USA.

Dafna D Gladman (DD)

Medicine, University of Toronto, Toronto, Ontario, Canada.
Medicine, Toronto Western Hospital, Toronto, Ontario, Canada.

Bevra Hahn (B)

Rheumatology, UCLA School of Medicine, Los Angeles, California, USA.

Falk Hiepe (F)

Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Søren Jacobsen (S)

Department of Rheumatology, Copenhagen Lupus and Vasculitis Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Dinesh Khanna (D)

Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.

Kirsten Lerstrøm (K)

Lupus Europe, Romford, UK.

Elena Massarotti (E)

Rheumatology, Harvard Medical School, Boston, Massachusetts, USA.
Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Joseph McCune (J)

Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA.

Guillermo Ruiz-Irastorza (G)

Autoimmune Diseases Unit, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, País Vasco, Spain.

Jorge Sanchez-Guerrero (J)

Medicine, Mount Sinai Hospital/University Health Network, University of Toronto, Toronto, Ontario, Canada.
Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion, Mexico City, Mexico.

Matthias Schneider (M)

Policlinic and Hiller Research Unit for Rheumatology, Medical Faculty,Heinrich-Heine-University, Düsseldorf, Germany.

Murray Urowitz (M)

Medicine, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

George Bertsias (G)

Rheumatology, University of Crete School of Medicine, Iraklio, Crete, Greece.
Laboratory of Autoimmunity-Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Crete, Greece.

Bimba F Hoyer (BF)

Rheumatology and Clinical Immunology, University of Schleswig-Holstein at Kiel, Kiel, Germany.

Nicolai Leuchten (N)

Medicine III, University Medical Center and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany.

Chiara Tani (C)

Rheumatology, Azienda Ospedaliero Universitaria Pisana, Pisa, Toscana, Italy.
Rheumatology, University of Pisa, Pisa, Toscana, Italy.

Sara K Tedeschi (SK)

Rheumatology, Harvard Medical School, Boston, Massachusetts, USA.
Medicine, Division of Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Zahi Touma (Z)

Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Gabriela Schmajuk (G)

Department of Medicine, Division of Rheumatology, University of California, San Francisco, San Francisco, California, USA.

Branimir Anic (B)

Division of Clinical Immunology and Rheumatology, Department of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.

Florence Assan (F)

INSERM UMR 1163, Université Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR 1184, Paris, France.

Tak Mao Chan (TM)

Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong.

Ann Elaine Clarke (AE)

Rheumatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

Mary K Crow (MK)

Mary Kirkland Center for Lupus Research, Hospital for Special Surgery, New York, New York, USA.

László Czirják (L)

Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.

Andrea Doria (A)

Division of Rheumatology, University of Padova, Padova, Italy.

Winfried B Graninger (WB)

Rheumatology and Immunology, Medical University Graz, Graz, Austria.

Bernadett Halda-Kiss (B)

Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.

Sarfaraz Hasni (S)

Rheumatology, NIAMS, National Institutes of Health, Bethesda, Maryland, USA.

Peter M Izmirly (PM)

Rheumatology, New York University School of Medicine, New York, New York, USA.

Michelle Jung (M)

Rheumatology, University of Calgary, Calgary, Alberta, Canada.

Gábor Kumánovics (G)

Department of Rheumatology and Immunology, University of Pécs, Pécs, Hungary.

Xavier Mariette (X)

Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR, Université Paris Sud, Le Kremlin-Bicêtre, France.

Ivan Padjen (I)

Division of Clinical Immunology and Rheumatology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia.

José M Pego-Reigosa (JM)

Rheumatology, University Hospital of Vigo, IRIDIS Group, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.

Juanita Romero-Diaz (J)

Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Tlalpan, Mexico.

Íñigo Rúa-Figueroa (Í)

Rheumatology, Dr Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.

Raphaèle Seror (R)

INSERM UMR 1163, Université Paris Sud, Hôpitaux Universitaires Paris-Sud, AP-HP, INSERM UMR 1184, Paris, France.

Georg H Stummvoll (GH)

Rheumatology, Medical University of Vienna, Vienna, Austria.

Yoshiya Tanaka (Y)

First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.

Maria G Tektonidou (MG)

Medical School, National and Kapodistrian University of Athens, Athinon, Greece.

Carlos Vasconcelos (C)

Centro Hospitalar do Porto, ICBAS, University of Porto, Porto, Portugal.

Edward M Vital (EM)

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

D J Wallace (DJ)

Rheumatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Sule Yavuz (S)

Rheumatology, Istanbul Bilim Universitesi, Istanbul, Turkey.

Pier Luigi Meroni (PL)

Clinical Immunology and Rheumatology, IRCCS Istituto Auxologico Italiano, Milan, Italy.

Marvin J Fritzler (MJ)

Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

Ray Naden (R)

Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.

Thomas Dörner (T)

Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Martin Aringer (M)

Rheumatology, University Medical Center and Faculty of Medicine Carl Gustav Carus, Dresden, Germany Sindhu.Johnson@uhn.ca martin.aringer@uniklinikum-dresden.de.

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