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Abstract Number: 2710

The New ACR-EULAR 2013 Systemic Sclerosis Classification Criteria Show Good Performance in a Capillaroscopy Clinic

Patricia E. Carreira1, M Jesus Garcia de Yebenes2, Beatriz E. Joven1,3, Estibaliz Loza2 and Loreto Carmona2, 1Rheumatology Department. Hospital Universitario 12 de Octubre, Madrid, Spain, 2Instituto de Salud Musculoesqueletica, Madrid, Spain, 3Rheumatology, HOSPITAL UNIVERSITARIO 12 DE OCTUBRE, Madrid, Spain

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Capillaroscopy, Classification criteria and scleroderma

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Session Information

Session Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics: Determinants of Disease, Classification and Response

Session Type: Abstract Submissions (ACR)

Background/Purpose:  To analyze the validity of the new 2013 ACR-EULAR Systemic Sclerosis (SSc) classification criteria versus SSc clinical diagnosis in patients from a capillaroscopy clinic

Methods: All patients seen for capillaroscopy between Jan2010 and Oct2013 (before criteria publication) were included. Having as gold standard the SSc diagnosis done by a rheumatologist, the performance (sensitivity, specificity, likelihood ratios) of the ACR-EULAR 2013 criteria, in full, and by items was analyzed. Receiver Operating Characteristic (ROC) curve and area under the curve (AUC) were calculated for global score, and best cut-off for the criteria score obtained

Results:

The study included 327 patients (84% women, 48±16 y). Reasons for capillaroscopy were Raynaud (40%), SSc evaluation (27%), other CTD with Raynaud (13%), CTD suspicion (10%), ischaemic lesions (1%) and others (9%). Final diagnosis was SSc in 106 (32%), idiopathic Raynaud (39%), SLE (13%), myopathy (8%), vascular related (6%), primary SS (3%) and others (30%).

The performance of the individual items in the criteria varied, being the best sclerodactily and capillaroscopic changes. The full criteria showed very high validity, with 98% sensitivity, 95% specificity and 18.6 positive likelihood ratio (Table 1). The best cut-offs of the criteria as a score were ≥8, ≥9 or ≥10 (Table 2). Finally, ROC curve showed an elevated discriminatory capacity for diagnosis of SSc, with AUC of 0.993 (Figure 1)

Conclusion: The new ACR-EULAR 2013 SSc classification criteria show high validity and discriminatory capacity for SSc clinical diagnosis done by rheumatologists in a capillaroscopy clinic setting



Disclosure:

P. E. Carreira,
None;

M. J. Garcia de Yebenes,
None;

B. E. Joven,
None;

E. Loza,
None;

L. Carmona,
None.

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