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Published on: February 8, 2019
ACR/EULAR-endorsed study to develop Diagnostic and Classification Criteria for Vasculitis (DCVAS)
Anthea Craven1, Joanna Robson2, Cristina Ponte3,4
1Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK. anthea.craven@ndorms.ox.ac.uk.
Insights
Developing new diagnostic and classification criteria for systemic vasculitis is crucial. The Diagnostic and Classification Criteria for Vasculitis (DCVAS) study aims to improve diagnosis and treatment for these rare inflammatory blood vessel diseases.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Systemic vasculitides are rare inflammatory blood vessel diseases.
- Current diagnostic criteria are lacking, leading to diagnostic delays.
- Advancements in understanding vasculitis necessitate updated classification criteria.
Purpose of the Study:
- To develop and validate new diagnostic criteria for primary systemic vasculitis.
- To improve and validate classification criteria for primary systemic vasculitis.
- To address limitations in current diagnostic and classification approaches.
Main Methods:
- Multinational observational study adhering to ACR/EULAR guidelines.
- Incorporates vessel size, clinical data, ANCA testing, biopsy, and imaging.
- Utilizes pre-defined cases and data-driven algorithms to mitigate circularity.
Main Results:
- Recruitment of over 2,000 vasculitis patients and 1,500 mimic cases.
- Data collection from over 100 centers across 31 countries.
- Aims to create a generalizable and comprehensive dataset.
Conclusions:
- The DCVAS study will provide validated criteria for diagnosing and classifying primary systemic vasculitis.
- Improved criteria are expected to enhance diagnostic accuracy and timely treatment.
- The study's large, diverse dataset will offer insights into vasculitis presentation and outcomes globally.
Abstract:
The systemic vasculitides are a group of uncommon diseases characterized by blood vessel inflammation. There are currently no diagnostic criteria for the primary systemic vasculitides and physicians must rely on experience and disease definitions. The absence of validated criteria can result in delays in making the correct diagnosis and starting appropriate therapy. With the increased understanding of the pathophysiology of vasculitis and newer diagnostic tests in widespread clinical use, it is an appropriate time for classification criteria for primary vasculitis to be revised. The Diagnostic and Classification Criteria for Vasculitis (DCVAS) study is a multinational observational study designed to develop and validate diagnostic criteria and to improve and validate classification criteria for primary systemic vasculitis. The analytic approach will be based on the traditional approach of vessel size for classification of vasculitis but will also incorporate detailed clinical data, evaluation of anti-neutrophil cytoplasm antibody diagnostic testing, biopsy and imaging data. The study is following the guidelines for the development of classification criteria established by the American College of Rheumatology and the European League against Rheumatism. The study will incorporate the use of pre-defined cases of each condition to reduce the inherent circularity when developing new classification criteria and will explore alternative approaches to deriving reference standards by creating data-driven classification algorithms. We anticipate recruiting >2,000 patients with primary systemic vasculitis and 1,500 patients with autoimmune diseases and other conditions that mimic vasculitis. As of June 2013, >100 medical centers across 31 countries in Asia, Australasia, Europe, North America, and South America were contributing data to the study. The DCVAS study provides a unique opportunity to increase generalizability and collate a large dataset on the occurrence, presentation, and outcome of vasculitis in different populations.
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