Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry

Allison Guttmann; Brendan Denvir; Martin Aringer; Jill P Buyon; H. Michael Belmont; Sara Sahl; Jane E Salmon; Anca Askanase; Joan M. Bathon; Laura Geraldino-pardilla; Yousaf Ali; Ellen M Ginzler; Chaim Putterman; Caroline Gordon; Charles G Helmick; Hilary Parton; Peter M. Izmirly

doi:10.1002/acr.24960

Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry

Allison Guttmann, Brendan Denvir, Martin Aringer, Jill P Buyon, H. Michael Belmont, Sara Sahl, Jane E Salmon, Anca Askanase, Joan M. Bathon, Laura Geraldino-pardilla, Yousaf Ali, Ellen M Ginzler, Chaim Putterman, Caroline Gordon, Charles G Helmick, Hilary Parton, Peter M. Izmirly

Inflammation and Ageing

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Abstract

Objective: Using the Manhattan Lupus Surveillance Program (MLSP), a multi-racial/ethnic population-based registry, we compared three commonly used classification criteria for Systemic Lupus Erythematosus (SLE) to identify unique cases and determine the incidence and prevalence of SLE using the EULAR/ACR criteria.

Methods: SLE cases were defined as fulfilling 1997 ACR, SLICC, or EULAR/ACR classification criteria. We quantified the number of cases uniquely associated with each and the number fulfilling all three. Prevalence and incidence using the EULAR/ACR classification criteria and associated 95% confidence intervals (CI) were calculated.

Results: 1,497 cases fulfilled at least one of the three classification criteria, with 1,008 (67.3%) meeting all three classifications, 138 (9.2%) fulfilling only SLICC criteria, 35 (2.3%) fulfilling only ACR criteria and 34 (2.3%) uniquely fulfilling EULAR/ACR criteria. Patients solely satisfying EULAR/ACR criteria had fewer than four manifestations. The majority classified only by the ACR criteria did not meet any of the defined immunologic criteria. Patients fulfilling only SLICC criteria did so based on the presence of features unique to this system. Using the EULAR/ACR classification criteria, age-adjusted overall prevalence and incidence rates of SLE in Manhattan were 59.6 (95%CI:55.9-63.4) and 4.9 (95%CI 4.3-5.5) per 100,000 population, with age-adjusted prevalence and incidence rates highest among non-Hispanic Black females.

Conclusion: Applying the three commonly used classification criteria to a population-based registry identified patients with SLE fulfilling only one validated definition. The most recently developed EULAR/ACR classification criteria revealed similar prevalence and incidence estimates to those previously established for the ACR and SLICC classification schemes.

Original language	English
Journal	Arthritis Care and Research
Early online date	31 May 2022
DOIs	https://doi.org/10.1002/acr.24960
Publication status	E-pub ahead of print - 31 May 2022

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Guttmann, A., Denvir, B., Aringer, M., Buyon, J. P., Belmont, H. M., Sahl, S., Salmon, J. E., Askanase, A., Bathon, J. M., Geraldino-pardilla, L., Ali, Y., Ginzler, E. M., Putterman, C., Gordon, C., Helmick, C. G., Parton, H., & Izmirly, P. M. (2022). Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry. Arthritis Care and Research. Advance online publication. https://doi.org/10.1002/acr.24960

@article{e9c324ec326f41808c4ff3e29a83d78c,

title = "Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry",

abstract = "Objective: Using the Manhattan Lupus Surveillance Program (MLSP), a multi-racial/ethnic population-based registry, we compared three commonly used classification criteria for Systemic Lupus Erythematosus (SLE) to identify unique cases and determine the incidence and prevalence of SLE using the EULAR/ACR criteria.Methods: SLE cases were defined as fulfilling 1997 ACR, SLICC, or EULAR/ACR classification criteria. We quantified the number of cases uniquely associated with each and the number fulfilling all three. Prevalence and incidence using the EULAR/ACR classification criteria and associated 95% confidence intervals (CI) were calculated.Results: 1,497 cases fulfilled at least one of the three classification criteria, with 1,008 (67.3%) meeting all three classifications, 138 (9.2%) fulfilling only SLICC criteria, 35 (2.3%) fulfilling only ACR criteria and 34 (2.3%) uniquely fulfilling EULAR/ACR criteria. Patients solely satisfying EULAR/ACR criteria had fewer than four manifestations. The majority classified only by the ACR criteria did not meet any of the defined immunologic criteria. Patients fulfilling only SLICC criteria did so based on the presence of features unique to this system. Using the EULAR/ACR classification criteria, age-adjusted overall prevalence and incidence rates of SLE in Manhattan were 59.6 (95%CI:55.9-63.4) and 4.9 (95%CI 4.3-5.5) per 100,000 population, with age-adjusted prevalence and incidence rates highest among non-Hispanic Black females.Conclusion: Applying the three commonly used classification criteria to a population-based registry identified patients with SLE fulfilling only one validated definition. The most recently developed EULAR/ACR classification criteria revealed similar prevalence and incidence estimates to those previously established for the ACR and SLICC classification schemes.",

author = "Allison Guttmann and Brendan Denvir and Martin Aringer and Buyon, {Jill P} and Belmont, {H. Michael} and Sara Sahl and Salmon, {Jane E} and Anca Askanase and Bathon, {Joan M.} and Laura Geraldino-pardilla and Yousaf Ali and Ginzler, {Ellen M} and Chaim Putterman and Caroline Gordon and Helmick, {Charles G} and Hilary Parton and Izmirly, {Peter M.}",

year = "2022",

month = may,

day = "31",

doi = "10.1002/acr.24960",

language = "English",

journal = "Arthritis Care and Research",

issn = "0893-7524",

publisher = "John Wiley & Sons",

}

Guttmann, A, Denvir, B, Aringer, M, Buyon, JP, Belmont, HM, Sahl, S, Salmon, JE, Askanase, A, Bathon, JM, Geraldino-pardilla, L, Ali, Y, Ginzler, EM, Putterman, C, Gordon, C, Helmick, CG, Parton, H & Izmirly, PM 2022, 'Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry', Arthritis Care and Research. https://doi.org/10.1002/acr.24960

TY - JOUR

T1 - Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry

AU - Guttmann, Allison

AU - Denvir, Brendan

AU - Aringer, Martin

AU - Buyon, Jill P

AU - Belmont, H. Michael

AU - Sahl, Sara

AU - Salmon, Jane E

AU - Askanase, Anca

AU - Bathon, Joan M.

AU - Geraldino-pardilla, Laura

AU - Ali, Yousaf

AU - Ginzler, Ellen M

AU - Putterman, Chaim

AU - Gordon, Caroline

AU - Helmick, Charles G

AU - Parton, Hilary

AU - Izmirly, Peter M.

PY - 2022/5/31

Y1 - 2022/5/31

N2 - Objective: Using the Manhattan Lupus Surveillance Program (MLSP), a multi-racial/ethnic population-based registry, we compared three commonly used classification criteria for Systemic Lupus Erythematosus (SLE) to identify unique cases and determine the incidence and prevalence of SLE using the EULAR/ACR criteria.Methods: SLE cases were defined as fulfilling 1997 ACR, SLICC, or EULAR/ACR classification criteria. We quantified the number of cases uniquely associated with each and the number fulfilling all three. Prevalence and incidence using the EULAR/ACR classification criteria and associated 95% confidence intervals (CI) were calculated.Results: 1,497 cases fulfilled at least one of the three classification criteria, with 1,008 (67.3%) meeting all three classifications, 138 (9.2%) fulfilling only SLICC criteria, 35 (2.3%) fulfilling only ACR criteria and 34 (2.3%) uniquely fulfilling EULAR/ACR criteria. Patients solely satisfying EULAR/ACR criteria had fewer than four manifestations. The majority classified only by the ACR criteria did not meet any of the defined immunologic criteria. Patients fulfilling only SLICC criteria did so based on the presence of features unique to this system. Using the EULAR/ACR classification criteria, age-adjusted overall prevalence and incidence rates of SLE in Manhattan were 59.6 (95%CI:55.9-63.4) and 4.9 (95%CI 4.3-5.5) per 100,000 population, with age-adjusted prevalence and incidence rates highest among non-Hispanic Black females.Conclusion: Applying the three commonly used classification criteria to a population-based registry identified patients with SLE fulfilling only one validated definition. The most recently developed EULAR/ACR classification criteria revealed similar prevalence and incidence estimates to those previously established for the ACR and SLICC classification schemes.

AB - Objective: Using the Manhattan Lupus Surveillance Program (MLSP), a multi-racial/ethnic population-based registry, we compared three commonly used classification criteria for Systemic Lupus Erythematosus (SLE) to identify unique cases and determine the incidence and prevalence of SLE using the EULAR/ACR criteria.Methods: SLE cases were defined as fulfilling 1997 ACR, SLICC, or EULAR/ACR classification criteria. We quantified the number of cases uniquely associated with each and the number fulfilling all three. Prevalence and incidence using the EULAR/ACR classification criteria and associated 95% confidence intervals (CI) were calculated.Results: 1,497 cases fulfilled at least one of the three classification criteria, with 1,008 (67.3%) meeting all three classifications, 138 (9.2%) fulfilling only SLICC criteria, 35 (2.3%) fulfilling only ACR criteria and 34 (2.3%) uniquely fulfilling EULAR/ACR criteria. Patients solely satisfying EULAR/ACR criteria had fewer than four manifestations. The majority classified only by the ACR criteria did not meet any of the defined immunologic criteria. Patients fulfilling only SLICC criteria did so based on the presence of features unique to this system. Using the EULAR/ACR classification criteria, age-adjusted overall prevalence and incidence rates of SLE in Manhattan were 59.6 (95%CI:55.9-63.4) and 4.9 (95%CI 4.3-5.5) per 100,000 population, with age-adjusted prevalence and incidence rates highest among non-Hispanic Black females.Conclusion: Applying the three commonly used classification criteria to a population-based registry identified patients with SLE fulfilling only one validated definition. The most recently developed EULAR/ACR classification criteria revealed similar prevalence and incidence estimates to those previously established for the ACR and SLICC classification schemes.

U2 - 10.1002/acr.24960

DO - 10.1002/acr.24960

M3 - Article

SN - 0893-7524

JO - Arthritis Care and Research

JF - Arthritis Care and Research

ER -

Evaluation of the European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus in a population based registry

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