Updated ACR/EULAR Criteria May Classify SLE Earlier

The 2019 American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) criteria can classify patients with systemic lupus erythematosus (SLE) earlier than with other criteria sets in real‐life clinical practice scenarios, researchers found.

A study team set out to determine whether 2019 criteria enabled earlier classification of patients with SLE when assessed against guidelines published by the ACR in 1982 and 1997 and the Systemic Lupus International Collaborating Clinics (SLICC) criteria issued in 2012.

The researchers turned to data from the LUMINA cohort of 554 participants.² In the LUMINA study, published in 2006, the team sought to identify factors predictive of high levels of disease activity in patients with SLE of varying ethnic, racial, geographic, and socioeconomic identifiers, classified according to the 1982/1997 ACR criteria.

The comparison of the 2019 EULAR/ACR criteria with the earlier systems, researchers found, allowed for earlier SLE classification in 13.3% of cases when compared with the ACR 1982/1997 criteria, and in 15.3% of cases when evaluated against the 2012 SLICC criteria. However, the researchers noted, the updated criteria could allow for earlier classification of patients with SLE with more severe disease.

“Patients accruing the 2019 EULAR/ACR later than the 1982/1997 ACR criteria had a lower disease activity, were less likely to have positivity to anti‐dsDNA and anti‐Sm as well as lupus nephritis type II or V,” the researchers concluded. “They were more likely to have mucocutaneous manifestations, serositis, leukopenia, and antiphospholipid antibodies positivity.”

—Rebecca Mashaw

References:

1. Ugarte‐Gil MF, Pons‐Estel GJ, Harvey GB, Vilá LM, Griffin R, Alarcón GS. Applying the 2019 EULAR/ACR lupus criteria to patients from the LUMINA cohort. Arthritis Care Res.  Published online June 29, 2020. https://doi.org/10.1002/acr.24367
2. Alarcón GS, Calvo-Alén J, McGwin Jr G, et al. Systemic lupus erythematosus in a multiethnic cohort: LUMINA XXXV. Predictive factors of high disease activity over time. Ann Rheum Dis. 2006;65(9):1168-1174. doi:10.1136/ard.200X.046896