Session Information
Date: Sunday, November 8, 2015
Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment I: Epidemiology and Prognosis
Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose: Systemic lupus erythematosus (SLE) is an autoimmune disease with heterogeneous presentations. Therefore, classification criteria are required to help improve diagnostic accuracy in clinical practice and particularly in research. This study aimed to compare the performance of 1982 and revised 1997 ACR classification criteria to the newer 2012 SLICC classification criteria.
Methods: Potential cases of incident SLE from 1993 to 2005 in a predominantly Caucasian, geographically well-defined population were identified from the health-care network diagnostic codes. Comprehensive individual medical record review was performed to determine the presence or absence of the ACR and SLICC criteria. An incident case of SLE was defined as an individual who fulfilled at least 4 out of 11, 1982 or revised 1997 ACR criteria or met at least 4 SLICC criteria (with at least 1 clinical and 1 laboratory criteria) or had biopsy-proven lupus nephritis with positive ANA or ds-DNA and had been a resident for at least 1 year prior to the first physician diagnosis of SLE. Cases with isolated cutaneous lupus, drug-induced lupus and overlapping diseases were excluded. Overall incidence was age- and sex-adjusted to the 2000 US white population.
Results: There were 59 incident cases who fulfilled the SLICC criteria, corresponding to the adjusted incidence of 3.8 per 100,000 population (95% CI, 2.8 – 4.8). The incidence was significantly higher than that of the 1982 (45 cases; 2.9 per 100,000 population; p=0.004) and revised 1997 ACR criteria (46 cases; 2.9 per 100,000 population; p=0.046). The average age of 42.8 +/- 18.6 years in the SLICC cohort was not significantly different compared to 40.9 +/- 18.0 years in the 1982 ACR cohort and 41.1 +/- 17.9 years in the revised 1997 ACR cohort (p=0.11). Arthritis (56%), followed by acute cutaneous lupus (46%), renal involvement (25%) and serositis (24%) were the most frequently observed clinical criteria while positive ANA (93%), followed by positive ds-DNA (63%) and hypocomplementemia (36% for C3, 42% for C4 and 22% for total complement) were the most common immunologic criteria. Three cases were diagnosed based on renal biopsy and positive ANA or ds-DNA without fulfilling 4 out of 17 SLICC criteria.
Conclusion: The 2012 SLICC classification criteria may be more sensitive than the 1982 and revised 1997 ACR classification criteria in identifying patients with SLE at population level.
To cite this abstract in AMA style:
Ungprasert P, Crowson CS, Chowdhary V. Performance of the Systemic Lupus International Collaborating Clinic Classification Criteria Versus the 1982 and Revised 1997 American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus: A Population-Based Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/performance-of-the-systemic-lupus-international-collaborating-clinic-classification-criteria-versus-the-1982-and-revised-1997-american-college-of-rheumatology-classification-criteria-for-systemic-lupu/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/performance-of-the-systemic-lupus-international-collaborating-clinic-classification-criteria-versus-the-1982-and-revised-1997-american-college-of-rheumatology-classification-criteria-for-systemic-lupu/