Updated SLE Criteria May Identify Additional Patients

Using the 2019 European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) criteria, researchers found that about 17% of patients with undifferentiated connective tissue disease (UCTD) can be reclassified as having systemic lupus erythematosus (SLE), according to new data.

The study included 133 women who, at the time of inclusion, did not meet the classification criteria for any other defined systemic disease of the connective tissues.
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The researchers found that 22 patients (17%) in fact met the updated EULAR/ACR classification criteria for SLE. These participants showed significantly higher frequency of mucocutaneous manifestations, arthritis, isolated urine abnormalities, and highly specific antibodies.

In addition, participants who were diagnosed with SLE earlier, according to the 1997 ACR and the Systemic Lupus International Collaborating Clinics (SLICC) criteria, were rescored during follow-up and found to have significantly higher scores based on the new 2019 EULAR/ACR classification criteria compared with other patients who were diagnosed with UCTD.

“When applying the 2019 EULAR/ACR criteria for SLE in a cohort of patients with UCTD, we observed that in up to 17% of cases the original classification could be challenged,” the researchers concluded. “New implementation will help to early identify patients at higher risk of developing more severe CTD manifestations.”

—Rebecca Mashaw

Reference:

Radin M, Schreiber K, Cecchi I, et al. Impact of the new 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in a multicenter cohort study of 133 women with undifferentiated connective tissue disease. Arthritis Care Res. Published online July 23, 2020. https://doi.org/10.1002/acr.24391