Date: Monday, October 22, 2018
Session 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.
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.
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 10). 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 July 11, 2020.
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