Evaluation of the Performance of the 2016 American College of Rheumatology-European League Against Rheumatism (Acr-Eular) Classification Criteria for Primary Sjogren`S Syndrome in Different Centers of Argentina

Hugo Najera¹, Marta Mamani², Anastasia Secco¹, Fernando Melo³, Cristian Troitiño⁴, Felix Romanini Sr.², Emmanuel Guerra², Antonio Catalan Pellet⁵, Silvia Beatriz Papasidero⁶, Rodrigo Aguila Maldonado⁷, Mercedes Garcia⁷, Mariano Rivero⁸, Juan Carlos Barreira⁹, ivan remolina¹⁰, A. perdomo¹¹, quevedo mayorga¹⁰, M.J. santacruz¹² and j demarchi¹⁰, ¹Rheumatology Section, Hospital Bernardino Rivadavia, CABA, Argentina, ²Hospital Bernardino Rivadavia, Buenos Aires, Argentina, ³Rheumatology Department, Hospital Bernardino Rivadavia, Buenos Aires, Argentina, ⁴Reumatologia, Hospital Bernardino Rivadavia, CAPITAL FEDERAL, Argentina, ⁵Rheumatology, Hospital Bernardino Rivadavia, Buenos Aires, Argentina, ⁶Rheumatology Section, Hospital General de Agudos Dr. Enrique Tornú, Argentina, Buenos Aires, Argentina, ⁷Rheumatology, HIGA General San Martin La Plata, La Plata, Argentina, ⁸Rheumatology, Consultorios Externos Vacarezza,Alberdi,Pcia Buenos Aires, Pcia Buenos Aires, Argentina, ⁹Rheumatology Unit, Hospital Británico, Buenos Aires, Buenos Aires, Argentina, ¹⁰hospital britanico, Buenos Aires, Argentina, ¹¹hospital nuestra señora de la merced, alberti, Argentina, ¹²hospital tornu, Buenos Aires, Argentina

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: autoimmune diseases, classification criteria, salivary gland and salivary hypofunction, Sjogren's syndrome

Session Information

Date: Monday, October 22, 2018

Title: Sjögren's Syndrome – Basic and Clinical Science Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Primary Sjögren`s Syndrome (pSS) is a multisystemic, autoimmunity disease, characterized mainly by the hypofunction of the salivary and lacrimal glands, however the clinical spectrum of this disease extends from SICCA symptoms to the presence of extra-glandular manifestations being able to compromise multiple systems. The recent 2016 ACR-EULAR classification criteria were designed to be applied not only in patients with dryness symptoms, but also in those with clinical manifestations included in the ESSDAI domains (EULAR primary Sjögren’s syndrome disease activity) which would allow to classify those patients who debuted with extra-glandular manifestations.

OBJETIVES

To evaluate the performance of the 2016 ACR-EULAR classification criteria for pSS in adult population of different centers in Argentina.

Methods: A multi-center study of 5 national centers was carried out. We included patients older than 18 years of age, who presented clinical and/or analytical manifestations suggestive of pSS. To discriminate between cases and controls, the opinion of experts from different centers, blind to the previous diagnosis of the patients, (with a degree of agreement ≥ 70%) was used as gold standard. The exclusion criteria were similar to those present in the 2002 American-European and the 2012 ACR classification criteria. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and positive likelihood ratio (LR +) were evaluated.

Results: A total of 226 patients were included, 97.3% were women, with an average age of 55 years (SD ± 12), and a mean duration of symptoms of 7.9 years (SD ± 6.8). 178 patients (78.7%) had a diagnosis of pSS according to expert opinion, of which 171/178 (96.1%) had xerophthalmia, 172/178 (96.6%) xerostomia, 162/178 (91%) positivity at least one domain of the ESSDAI and 3/178 (1.7%) did not present xerostomia or xerophthalmia at the time of diagnosis. A sensitivity of 94.9% (95% IC: 92.1 – 97.8%), a specificity of 95.8% (95% IC: 93.2 – 98.4%), a PPV of 98.8% (95% IC: 97.4 – 100%), a NPV of 83.6% (95% IC: 78.8 – 88.4%) and an LR + of 22.7 (95% IC: 13.6 – 62.7) was obtained.

Conclusion: The recent classificatory criteria showed a performance comparable to the precedents 2002 American-European and 2012 ACR classification criteria, with the advantage that the new ones allow to classify those patients who debuted with extra-glandular manifestations.

Disclosure: H. Najera, None; M. Mamani, None; A. Secco, None; F. Melo, None; C. Troitiño, None; F. Romanini Sr., None; E. Guerra, None; A. Catalan Pellet, None; S. B. Papasidero, None; R. Aguila Maldonado, None; M. Garcia, None; M. Rivero, None; J. C. Barreira, None; I. remolina, None; A. perdomo, None; Q. mayorga, None; M. J. santacruz, None; J. demarchi, None.

To cite this abstract in AMA style:

Najera H, Mamani M, Secco A, Melo F, Troitiño C, Romanini F Sr., Guerra E, Catalan Pellet A, Papasidero SB, Aguila Maldonado R, Garcia M, Rivero M, Barreira JC, remolina I, perdomo A, mayorga Q, santacruz MJ, demarchi J. Evaluation of the Performance of the 2016 American College of Rheumatology-European League Against Rheumatism (Acr-Eular) Classification Criteria for Primary Sjogren`S Syndrome in Different Centers of Argentina [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/evaluation-of-the-performance-of-the-2016-american-college-of-rheumatology-european-league-against-rheumatism-acr-eular-classification-criteria-for-primary-sjogrens-syndrome-in-different-centers-of/. Accessed .

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