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Article: 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus

Title2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus
Authors
Keywordsarthritis
cranial neuropathy
cytopenia
Delphi study
disease classification
Issue Date2019
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2326-5205
Citation
Arthritis & Rheumatology, 2019, v. 71 n. 9, p. 1400-1412 How to Cite?
AbstractObjective: To develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Methods: This international initiative had four phases. 1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta‐regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort, and a patient survey. 2) Criteria reduction by Delphi and nominal group technique exercises. 3) Criteria definition and weighting based on criterion performance and on results of a multi‐criteria decision analysis. 4) Refinement of weights and threshold scores in a new derivation cohort of 1,001 subjects and validation compared with previous criteria in a new validation cohort of 1,270 subjects. Results: The 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in 7 clinical (constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and 3 immunologic (antiphospholipid antibodies, complement proteins, SLE‐specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria. Conclusion: These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered, and weighted criteria reflects current thinking about SLE and provides an improved foundation for SLE research.
Persistent Identifierhttp://hdl.handle.net/10722/289378
ISSN
2019 Impact Factor: 9.586
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAringer, M-
dc.contributor.authorCostenbader, K-
dc.contributor.authorDaikh, D-
dc.contributor.authorBrinks, R-
dc.contributor.authorMosca, M-
dc.contributor.authorRamsey‐Goldman, R-
dc.contributor.authorSmolen, JS-
dc.contributor.authorWofsy, D-
dc.contributor.authorBoumpas, DT-
dc.contributor.authorKamen, DL-
dc.contributor.authorJayne, D-
dc.contributor.authorCervera, R-
dc.contributor.authorCostedoat‐Chalumeau, N-
dc.contributor.authorDiamond, B-
dc.contributor.authorGladman, DD-
dc.contributor.authorHahn, B-
dc.contributor.authorHiepe, F-
dc.contributor.authorJacobsen, S-
dc.contributor.authorKhanna, D-
dc.contributor.authorLerstrøm, K-
dc.contributor.authorMassarotti, E-
dc.contributor.authorMcCune, J-
dc.contributor.authorRuiz‐Irastorza, G-
dc.contributor.authorSanchez‐Guerrero, J-
dc.contributor.authorSchneider, M-
dc.contributor.authorUrowitz, M-
dc.contributor.authorBertsias, G-
dc.contributor.authorHoyer, BF-
dc.contributor.authorLeuchten, N-
dc.contributor.authorTani, C-
dc.contributor.authorTedeschi, SK-
dc.contributor.authorTouma, Z-
dc.contributor.authorSchmajuk, G-
dc.contributor.authorAnic, B-
dc.contributor.authorAssan, F-
dc.contributor.authorChan, TM-
dc.contributor.authorClarke, AE-
dc.contributor.authorCrow, MK-
dc.contributor.authorCzirják, L-
dc.contributor.authorDoria, A-
dc.contributor.authorGraninger, W-
dc.contributor.authorHalda‐Kiss, B-
dc.contributor.authorHasni, S-
dc.contributor.authorIzmirly, PM-
dc.contributor.authorJung, M-
dc.contributor.authorKumánovics, G-
dc.contributor.authorMariette, X-
dc.contributor.authorPadjen, I-
dc.contributor.authorPego‐Reigosa, JM-
dc.contributor.authorRomero‐Diaz, J-
dc.contributor.authorRúa‐Figueroa Fernández, I-
dc.contributor.authorSeror, R-
dc.contributor.authorStummvoll, GH-
dc.contributor.authorTanaka, Y-
dc.contributor.authorTektonidou, MG-
dc.contributor.authorVasconcelos, C-
dc.contributor.authorVital, EM-
dc.contributor.authorWallace, DJ-
dc.contributor.authorYavuz, S-
dc.contributor.authorMeroni, PL-
dc.contributor.authorFritzler, MJ-
dc.contributor.authorNaden, R-
dc.contributor.authorDörner, T-
dc.contributor.authorJohnson, SR-
dc.date.accessioned2020-10-22T08:11:47Z-
dc.date.available2020-10-22T08:11:47Z-
dc.date.issued2019-
dc.identifier.citationArthritis & Rheumatology, 2019, v. 71 n. 9, p. 1400-1412-
dc.identifier.issn2326-5191-
dc.identifier.urihttp://hdl.handle.net/10722/289378-
dc.description.abstractObjective: To develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Methods: This international initiative had four phases. 1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta‐regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort, and a patient survey. 2) Criteria reduction by Delphi and nominal group technique exercises. 3) Criteria definition and weighting based on criterion performance and on results of a multi‐criteria decision analysis. 4) Refinement of weights and threshold scores in a new derivation cohort of 1,001 subjects and validation compared with previous criteria in a new validation cohort of 1,270 subjects. Results: The 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in 7 clinical (constitutional, hematologic, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and 3 immunologic (antiphospholipid antibodies, complement proteins, SLE‐specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria. Conclusion: These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered, and weighted criteria reflects current thinking about SLE and provides an improved foundation for SLE research.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2326-5205-
dc.relation.ispartofArthritis & Rheumatology-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectarthritis-
dc.subjectcranial neuropathy-
dc.subjectcytopenia-
dc.subjectDelphi study-
dc.subjectdisease classification-
dc.title2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus-
dc.typeArticle-
dc.identifier.emailChan, TM: dtmchan@hkucc.hku.hk-
dc.identifier.authorityChan, TM=rp00394-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/art.40930-
dc.identifier.pmid31385462-
dc.identifier.pmcidPMC6827566-
dc.identifier.scopuseid_2-s2.0-85070692104-
dc.identifier.hkuros315894-
dc.identifier.volume71-
dc.identifier.issue9-
dc.identifier.spage1400-
dc.identifier.epage1412-
dc.identifier.isiWOS:000483727200005-
dc.publisher.placeUnited States-

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