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Evolving concepts in classification of systemic vasculitis: where are we and what is the way forward?

Richard A Watts1,2,3

  • 1Ipswich Hospital NHS Trust, Ipswich, UK.

International Journal of Rheumatic Diseases
|May 1, 2018
PubMed

Insights

New criteria are needed for classifying systemic vasculitides, as current definitions are outdated. The Diagnostic and Classification Criteria of Vasculitis study (DCVAS) aims to provide updated, validated criteria for these complex inflammatory conditions.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Systemic vasculitis classification has been debated for decades.
  • Current American College of Rheumatology (ACR) criteria (1990) are considered outdated.
  • Recent evidence challenges traditional ANCA-associated vasculitis and large-vessel vasculitis classifications.

Purpose of the Study:

  • To address the need for updated and validated classification criteria for systemic vasculitides.
  • To re-evaluate the classification of ANCA-associated vasculitides based on ANCA specificity.
  • To refine the distinction between giant cell arteritis and Takayasu arteritis.

Main Methods:

  • The Diagnostic and Classification Criteria of Vasculitis study (DCVAS) is developing new criteria.
  • Utilizing epidemiological, genetic, and outcome data to inform classification.
  • Incorporating evidence challenging existing clinical phenotype divisions.

Main Results:

  • The study aims to provide new, validated classification criteria.
  • Evidence suggests reclassifying ANCA vasculitides by ANCA specificity (PR3-ANCA vs. MPO-ANCA).
  • Re-evaluation of giant cell arteritis and Takayasu arteritis distinctions is underway.

Conclusions:

  • Existing classification systems for systemic vasculitides require revision.
  • New criteria are essential for accurate diagnosis and research.
  • The DCVAS study will offer a modern framework for vasculitis classification.

Keywords:
ANCAclassification criteriavasculitis

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