What is it about?
The classification criteria for Systemic lupus erythematosus (SLE) are fundamental for selecting patients for clinical trials and observational sudies and are often used to assist diagnosis. The SLE diagnosis remains largely clinical and dependent on the expertise/opinion of clinicians, since there are no established tests or diagnostic criteria. The sensitivity of the 'classical' ACR classification criteria for SLE is not optimal. Recently, the new SLICC criteria set was validated and its main advantage is a potentially higher sensitivity to identify lupus patients. We compared in this study the sensitivity of the ACR and SLICC criteria to identify SLE cases in a large multicenter, international cohort of patients from real-life clinical practice.
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Why is it important?
We showed that the SLICC criteria allows to identify as SLE cases a larger proportion of patients with a established clinical diagnosis of SLE. Importantly, the improved sensitivity was larger for those patients with a shorter disease duration. Furthermore, the large majority of patients classified as SLE with the ACR criteria were also positively identified by the SLICC criteria.
Perspectives
Performance of the SLICC criteria is better for identifying a larger proportion of SLE patients and importantly, earlier in the diasease course, as compared with the 'classical' ACR criteria. This is important for research purposes and also to assist in the clinical practice. However, as usual there is a trade-off between sensitivity and specificity, with the latter being lower with the SLICC criteria. For diagnosis, the clinical diagnosis established by an SLE expert remains the 'gold-standard'. Important unanswered questions remain: Are clinical outcomes similar for lupus cases defined with the ACR or the SLICC criteria? Which classification criteria should be applied as standard for research from now on? - Use of a standard case-definition across studies is important to maximize comparability.
Prof. Luís Sousa Ines
Universidade da Beira Interior
Read the Original
This page is a summary of: Classification of Systemic Lupus Erythematosus: Systemic Lupus International Collaborating Clinics Versus American College of Rheumatology Criteria. A Comparative Study of 2,055 Patients From a Real-Life, International Systemic Lupus Erythematosus Cohort, Arthritis Care & Research, July 2015, Wiley,
DOI: 10.1002/acr.22539.
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