In:
Annals of the Rheumatic Diseases, BMJ, Vol. 80, No. Suppl 1 ( 2021-06), p. 635.1-635
Abstract:
In 2019 ACR and EULAR published in joint collaboration the new classification criteria for Systemic Lupus Erythematosus (SLE). Compared to the previous ones, these criteria have shown higher sensitivity and specificity in multiple cohorts. To our knowledge, its performance has not been evaluated in a cohort of patients with rheumatological diseases living in Argentina. Objectives: The aim of this study was to evaluate the sensitivity and specificity of the ACR/ EULAR 2019 criteria in a cohort of patients with connective tissue diseases residing in Argentina. Secondary objectives were to determine the Likelihood Ratio (LR) of these criteria and the correlation of their global score with activity and damage indexes of the disease. Methods: Multicentre, retrospective and analytical study. Patients ≥ 18 years old with diagnosis of SLE (ACR 1997/SLICC 2012) without other associated collagen diseases (case group), and patients with other non-SLE connective tissue diseases (control group) were included. Those with active infectious disease, oncohematological disease, drug-induced lupus and overlap syndrome were excluded. Sociodemographic data, characteristics of the disease and treatment were recorded. In addition, activity and damage indexes were recorded in the group with SLE. Three SLE experts, blinded to the diagnosis determined, for every individual if the patient had SLE or another rheumatological disease. An interrater agreement of 100% (including the 3 evaluators) was considered “defined SLE” and used as gold standard. In all cases, ACR 1997/SLICC 2012/ACR / EULAR 2019 criteria were applied and compared with the gold standard. Statistical analysis : Descriptive statistics was estimated. Sensitivity, specificity, positive and negative LR of the criteria were determined. The association between the final score of the ACR-EULAR 2019 criteria and the disease activity and damage indexes were estimated with Spearman correlation test. STATA 15.0 was used for data analysis. Results: A total of 365 patients from 7 centres in Argentina were included. A One hundred and eighty-three belonged to the SLE group: 92.3% women, mean age 39 years (SD 13.3), median disease duration 92 months (IQR 37-150). The most frequent manifestations of the disease were mucocutaneous (94%), musculoskeletal (82.5%) and haematological (69%). All patients presented ANA +, 88% hypocomplementemia, 69.4% Anti-DNA and 19.5% antiphospholipid antibodies. Median SLEDAI and SLICC were 2 (IQR 0-6) and 0 (IQR 0-1), respectively. In the control group, 182 patients were recruited: 84% women, mean age 53.6 years (SD 14.2) and median disease duration 82.5 months (IQR 38-151). The most frequent diseases were Rheumatoid Arthritis (46.1%), Scleroderma (18.1%) and Sjögren’s Syndrome (16.5%) and most common manifestations were musculoskeletal (81.9%), immunological (73.6%) and constitutional (25.3%). A total of 62.6% of patients presented ANA+, 8.6% hypocomplementemia, and 1.3% Antiphospholipid antibodies. Ninety-one percent of patients in the case group were classified as defined SLE and 3.8% in the control group. The ACR / EULAR 2019 Criteria showed a 99.4% sensitivity and an 89.1% specificity, with a LR+ of 9.1 and a LR- of 0.007. The sensitivity and specificity of SLICC 2012 criteria were 98.3% and 88%, respectively with a LR+ of 8.2 and a LR- of 0.02; and the ACR 1997 criteria showed a 93.96% sensitivity and 90.1% specificity, with LR + of 8.21 and LR - of 0.07. The correlations between the ACR/EULAR 2019 Criteria global score, and activity and damage indexes were 0.19 and -0.006, respectively. Conclusion: The new ACR / EULAR 2019 criteria have shown high sensitivity, a specificity comparable to its predecessors, and a higher ability to distinguish SLE from other diseases and to exclude it in non-SLE patients. No correlation was observed between the criteria scores and activity and damage indexes. References: [1]Aringer M, Costenbader K, Daikh D, et al 2019 EULAR/ACR classification criteria for SLE. Ann Rheum 2019; 78: 1151-1159. Disclosure of Interests: None declared
Type of Medium:
Online Resource
ISSN:
0003-4967
,
1468-2060
DOI:
10.1136/annrheumdis-2021-eular.3172
Language:
English
Publisher:
BMJ
Publication Date:
2021
detail.hit.zdb_id:
1481557-6
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