New 2019 Criteria for Systemic Lupus Better Than ACR Criteria

New Systemic Lupus Erythematosus (SLE) Criteria Perform Well

New 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria have continued to be studied and reported in the medical literature. New studies by Johnson et al. suggest these criteria perform well among both men and women as well as across patents with different ethnicities and even in early systemic lupus erythematosus (SLE).

The 2019 EULAR/ACR Criteria for Lupus

The 2019 EULAR/ACR classification criteria for SLE were published in 2019 in the report by Aringer et al.

The EULAR/ACR Critieria

The criteria include a mandatory positive ANA at least once as a starting criterion. After that there are additive weighted criteria grouped in 7 clinical and 3 immunological domains. The 7 clinical domains include constitutional, haematological, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, and renal. The 3 immunological domains include antiphospholipid antibodies, complement proteins, SLE-specific antibodies) domains, and weighted from 2 to 10. Patients accumulating ≥10 points are classified.

2019 EULAR/ACR Criteria. From Aringer et al. Arthritis Rheumatol. 2019. PMID: 31385462

How good are the criteria?

The new criteria had a sensitivity of 96.1% and specificity of 93.4%. This compares to 82.8% sensitivity and 93.4% specificity of the ACR 1997 and 96.7% sensitivity and 83.7% specificity of the Systemic Lupus International Collaborating Clinics 2012 criteria.

REFERENCE

Aringer et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019. PMID: 31385462 

Johnson SR et al. Performance of the 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in early disease, across sexes and ethnicities. Published online August 14, 2020. Ann Rheum Dis. doi:10.1136/annrheumdis-2020-217162