2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus

被引：163

作者：

Aringer, Martin ^{[1
,2
]}

Costenbader, Karen ^{[3
]}

Daikh, David ^{[4
,5
]}

Brinks, Ralph ^{[6
]}

Mosca, Marta ^{[7
]}

Ramsey-Goldman, Rosalind ^{[8
]}

Smolen, Josef S. ^{[9
]}

Wofsy, David ^{[10
]}

Boumpas, Dimitrios T. ^{[11
,12
,13
,14
]}

Kamen, Diane L. ^{[15
]}

Jayne, David ^{[16
]}

Cervera, Ricard ^{[17
]}

Costedoat-Chalumeau, Nathalie ^{[18
]}

Diamond, Betty ^{[19
]}

Gladman, Dafna D. ^{[20
]}

Hahn, Bevra ^{[21
]}

Hiepe, Falk ^{[22
,23
,24
,25
]}

Jacobsen, Soren ^{[26
]}

Khanna, Dinesh ^{[27
]}

Lerstrom, Kirsten ^{[28
]}

Massarotti, Elena ^{[29
,30
]}

McCune, Joseph ^{[27
]}

Ruiz-Irastorza, Guillermo ^{[31
]}

Sanchez-Guerrero, Jorge ^{[32
,33
]}

Schneider, Matthias ^{[34
]}

Urowitz, Murray ^{[35
]}

Bertsias, George ^{[36
]}

Hoyer, Bimba F. ^{[22
,23
,24
,25
,37
]}

Leuchten, Nicolai ^{[1
,2
]}

Tani, Chiara ^{[38
]}

Tedeschi, Sara K. ^{[30
,39
]}

Touma, Zahi ^{[40
]}

Schmajuk, Gabriela ^{[4
,5
]}

Anic, Branimir ^{[41
,42
]}

Assan, Florence ^{[43
]}

Chan, Tak Mao ^{[44
]}

Clarke, Ann Elaine ^{[45
]}

Crow, Mary K. ^{[46
]}

Czirjak, Laszlo ^{[47
]}

Doria, Andrea ^{[48
]}

Graninger, Winfried ^{[49
]}

Halda-Kiss, Bernadett ^{[47
]}

Hasni, Sarfaraz ^{[50
]}

Izmirly, Peter M. ^{[51
]}

Jung, Michelle ^{[45
]}

Kumanovics, Gabor ^{[47
]}

Mariette, Xavier ^{[52
,53
]}

Padjen, Ivan ^{[41
,42
]}

Pego-Reigosa, Jose M. ^{[54
]}

Romero-Diaz, Juanita ^{[55
]}

机构：

[1] Tech Univ Dresden, Univ Med Ctr, Med 3, D-01307 Dresden, Germany

[2] Tech Univ Dresden, Fac Med Carl Gustav Carus, D-01307 Dresden, Germany

[3] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA

[4] Univ Calif San Francisco, San Francisco, CA 94143 USA

[5] VA Med Ctr, San Francisco, CA USA

[6] Heinrich Heine Univ Duesseldorf, Fac Med, Policlin & Hiller Res Unit Rheumatol, Dusseldorf, Germany

[7] Univ Pisa, Azienda Osped Univ Pisana, Dept Clin & Expt Med, Pisa, Italy

[8] Northwestern Univ, Dept Med, Feinberg Sch Med, Div Rheumatol, Chicago, IL 60611 USA

[9] Med Univ Vienna, Dept Rheumatol, Med 3, Vienna, Austria

[10] Univ Calif San Francisco, Dept Med, Russell Engleman Rheumatol Res Ctr, San Francisco, CA 94143 USA

[11] Natl & Kapodestrian Univ Athens, Sch Med, Joint Acad Rheumatol Program, Athens, Greece

[12] Athens Acad, Biomed Res Fdn, Athens, Greece

[13] Univ Cyprus, Sch Med, Dept Internal Med & Rheumatol, Nicosia, Cyprus

[14] Univ Cyprus, Sch Med, Dept Clin Immunol & Allergy, Nicosia, Cyprus

[15] Med Univ South Carolina, Dept Med, Charleston, SC 29425 USA

[16] Univ Cambridge, Dept Med, Cambridge, England

[17] Univ Barcelona, Hosp Clin, Dept Autoimmune Dis, Barcelona, Spain

[18] Univ Toronto, Mt Sinai Hosp, Toronto Scleroderma Res Program, Med,Toronto Western Hosp,Univ Hlth Network, Toronto, ON, Canada

[19] Feinstein Inst Med Res, Ctr Autoimmune Musculoskeletal & Hematopoiet Dis, Manhasset, NY USA

[20] Univ Toronto, Toronto Western Hosp, Dept Med, Div Rheumatol, Toronto, ON, Canada

[21] Univ Calif Los Angeles, David Geffen Sch Med, Div Rheumatol, Los Angeles, CA 90095 USA

[22] Charite Univ Med Berlin, Dept Rheumatol & Clin Immunol, Berlin, Germany

[23] Free Univ Berlin, Berlin, Germany

[24] Humboldt Univ, Berlin, Germany

[25] Berlin Inst Hlth, Berlin, Germany

[26] Copenhagen Univ Hosp, Rigshosp, Ctr Rheumatol & Spine Dis, Copenhagen Lupus & Vasculitis Clin, Copenhagen, Denmark

[27] Univ Michigan, Div Rheumatol, Ann Arbor, MI 48109 USA

[28] Lupus Europe, Coopted Trustee Res, Romford, Essex, England

[29] Brigham & Womens Hosp, Med, 75 Francis St, Boston, MA 02115 USA

[30] Harvard Med Sch, Dept Med, Boston, MA 02115 USA

[31] Univ Basque Country, Hosp Univ Cruces, Biocruces Bizkaia Hlth Res Inst, Autoimmune Dis Res Unit,Dept Internal Med, Bizkaia, Spain

[32] Univ Toronto, Univ Hlth Network, Mt Sinai Hosp, Div Rheumatol,Dept Med, Toronto, ON, Canada

[33] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Immunol & Rheumatol, Mexico City, DF, Mexico

[34] Heinrich Heine Univ, Fac Med, Policlin & Hiller Res Unit Rheumatol, Dusseldorf, Germany

[35] Univ Toronto, Toronto Western Hosp, Lupus Clin, Ctr Prognosis Studies Rheumat Dis, Toronto, ON, Canada

[36] Univ Crete, Sch Med, Rheumatol Clin Immunol & Allergy, Iraklion, Greece

[37] Univ Schleswig Holstein Kiel, Dept Med 3, Kiel, Germany

[38] Univ Pisa, Azienda Osped Univ Pisana, Dept Clin & Expt Med, Rheumatol Unit, Pisa, Italy

[39] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[40] Univ Toronto, Toronto Western Hosp, Inst Hlth Policy Management & Evaluat, Div Rheumatol,Dept Med, Toronto, ON, Canada

[41] Univ Zagreb, Sch Med, Div Clin Immunol & Rheumatol, Zagreb, Croatia

[42] Univ Hosp Ctr Zagreb, Zagreb, Croatia

[43] Univ Paris Sud, Hop Univ Paris Sud, AP HP, Dept Rheumatol,INSERM,UMR 1184, Le Kremlin Bicetre, France

[44] Univ Hong Kong, Dept Med, Hong Kong, Peoples R China

[45] Univ Calgary, Cumming Sch Med, Div Rheumatol, Calgary, AB, Canada

[46] Hosp Special Surg, 535 E 70th St, New York, NY 10021 USA

[47] Univ Pecs, Dept Rheumatol & Immunol, Pecs, Hungary

[48] Univ Padua, Dept Med DIMED, Rheumatol Unit, Padua, Italy

[49] Med Univ Graz, Internal Med, Graz, Austria

[50] NIAMSD, Lupus Clin Res Program, Off Clin Director, NIH, Bethesda, MD 20892 USA

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2019年 / 78卷 / 09期

关键词：

INTERNATIONAL COLLABORATING CLINICS; REVISED CRITERIA; MECHANISMS; DISEASE;

D O I：

10.1136/annrheumdis-2018-214819

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To develop new classification criteria for systemic lupus erythematosus (SLE) jointly supported by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR). Methods This international initiative had four phases. (1) Evaluation of antinuclear antibody (ANA) as an entry criterion through systematic review and meta-regression of the literature and criteria generation through an international Delphi exercise, an early patient cohort and a patient survey. (2) Criteria reduction by Delphi and nominal group technique exercises. (3) Criteria definition and weighting based on criterion performance and on results of a multi-criteria decision analysis. (4) Refinement of weights and threshold scores in a new derivation cohort of 1001 subjects and validation compared with previous criteria in a new validation cohort of 1270 subjects. Results The 2019 EULAR/ACR classification criteria for SLE include positive ANA at least once as obligatory entry criterion; followed by additive weighted criteria grouped in seven clinical (constitutional, haematological, neuropsychiatric, mucocutaneous, serosal, musculoskeletal, renal) and three immunological (antiphospholipid antibodies, complement proteins, SLE-specific antibodies) domains, and weighted from 2 to 10. Patients accumulating >= 10 points are classified. In the validation cohort, the new criteria had a sensitivity of 96.1% and specificity of 93.4%, compared with 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. Conclusion These new classification criteria were developed using rigorous methodology with multidisciplinary and international input, and have excellent sensitivity and specificity. Use of ANA entry criterion, hierarchically clustered and weighted criteria reflect current thinking about SLE and provide an improved foundation for SLE research.

引用

页码：1151 / 1159

页数：9

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