Comparison of the 2016 ACR/EULAR and the 2002 AECG Classification Criteria in a Cohort of Patients with Suspected Primary SjöGren’s Syndrome

Divi Cornec¹, Maëlle Le Goff², Sandrine Jousse-Joulin³, Dewi Guellec⁴, Sebastian Costa⁵, Thierry Marhadour⁶, Jacques-Olivier Pers⁷, Alain Saraux⁸ and Valerie Devauchelle-Pensec⁹, ¹Department of rheumatology, Brest Occidentale University, Brest, France, ²CHRU Brest, Brest, France, ³Rheumatology, CHu La cavle Blanche, Brest, France, ⁴Rheumatology Department, CHU de la Cavale Blanche, Brest, France, ⁵anatomopathological department, Brest university hospital, Brest, France, ⁶Rheumatology, CHU La Cavale Blanche, Brest, France, ⁷INSERM ERI29, EA2216, Université de Brest, Labex IGO, CHRU Morvan, Brest, France, ⁸Rheumatology Department, CHU de la Cavale Blanche, Brest Cedex, France, ⁹Rheumatology Department, Brest University Hospital, Brest, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Sjogren's syndrome and classification criteria

Session Information

Date: Tuesday, November 15, 2016

Title: Sjögren's Syndrome - Poster II: Clinical Science

Session Type: ACR Poster Session C

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

Background/Purpose: New consensual classification criteria for primary Sjögren’s syndrome (pSS) have been recently developed, validated, and submitted to ACR and EULAR committees. They differ substantially from previously used AECG criteria in that they consider systemic involvement (defined as ESSDAI score ≥1) as well as sicca symptoms as entry criteria before applying a weighted score. Evaluation of the concordance and differences between the two sets of criteria in independent patient populations is mandatory to establish how future clinical studies using the new criteria will be comparable to previously published studies.

Methods: This cross-sectional study was conducted in the monocentric Brittany cohort (DIApSS cohort) of patients with suspected pSS (sicca symptoms, parotidomegaly or extraglandular manifestations suggestive of pSS). All patients had standardized clinical examination, basic biology, immunological tests and minor labial salivary gland biopsy. Major salivary gland ultrasonography (SGUS) in mode B was performed in all patients by the same experienced operator, who was blinded to the diagnosis. Agreement between the two sets of criteria was assessed using Cohen’s κ coefficient and the characteristics of discordant patients were detailed.

Results: 163 patients were prospectively included between 2006 and 2016. Mean age was 56±14 years, female percentage 94%, and mean duration of the symptoms 6.8±7.9 years. More patients fulfilled ACR/EULAR criteria (n=93, 57%) than AECG criteria (n=83, 51%). 80 patients (49%) fulfilled both criteria, 13 (8%) fulfilled ACR/EULAR only, 3 (2%) AECG only and 67 (41%) none of the criteria. Concordance between both criteria was good (kappa=0.8, agreement 90%). Compared to patients fulfilling both criteria, patients fulfilling ACR/EULAR but not AECG criteria (n = 13) had similar age (56 vs 57 years), shorter disease duration (mean 5.9±8.5 vs 8.2±8.9 years), less frequent sicca symptoms (eye dryness 50% vs 96%, mouth dryness 64% vs 96%) and salivary gland swelling (14% vs 28%). They had characteristic features of pSS, with frequent systemic involvement at diagnosis (88%), positive salivary gland biopsy (86%), abnormal SGUS (67%) and presence of anti-SSA/SSB autoantibodies (57%). Among patients negative for the two sets of criteria, 10% had an abnormal SGUS and received a clinical diagnosis of pSS based on physician opinion.

Conclusion: Agreement between AECG criteria and new ACR/EULAR criteria is good suggesting that they select quite similar patients. ACR/EULAR criteria display a slightly higher sensitivity and are able to detect more patients with early disease and systemic involvement. As previously demonstrated for AECG criteria, SGUS inclusion into ACR/EULAR criteria may further enhance their sensitivity.

Disclosure: D. Cornec, None; M. Le Goff, None; S. Jousse-Joulin, None; D. Guellec, None; S. Costa, None; T. Marhadour, None; J. O. Pers, None; A. Saraux, None; V. Devauchelle-Pensec, None.

To cite this abstract in AMA style:

Cornec D, Le Goff M, Jousse-Joulin S, Guellec D, Costa S, Marhadour T, Pers JO, Saraux A, Devauchelle-Pensec V. Comparison of the 2016 ACR/EULAR and the 2002 AECG Classification Criteria in a Cohort of Patients with Suspected Primary SjöGren’s Syndrome [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/comparison-of-the-2016-acreular-and-the-2002-aecg-classification-criteria-in-a-cohort-of-patients-with-suspected-primary-sjogrens-syndrome/. Accessed .

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-the-2016-acreular-and-the-2002-aecg-classification-criteria-in-a-cohort-of-patients-with-suspected-primary-sjogrens-syndrome/