New EULAR/ACR 2019 SLE Classification Criteria: defining ominosity in SLE

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with variable severity.
• Accurate classification criteria are crucial for early diagnosis and prognosis.
• The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria aim to standardize SLE classification.

Purpose of the Study:

• To evaluate the prognostic value of the EULAR/ACR Systemic Lupus Erythematosus Classification Criteria.
• To determine if the EULAR/ACR criteria can predict disease severity in the first five years post-diagnosis.
• To assess the predictive role of the EULAR/ACR score for key indicators of SLE disease activity.

Main Methods:

• A cohort of 867 patients diagnosed with SLE within the first 12 months were analyzed.
• EULAR/ACR criteria scores were calculated using baseline data.
• Disease severity outcomes included adjusted mean SLE Disease Activity Index 2000 (AMS), flares, remission rates, and immunosuppressive treatment use over five years. The Systemic Lupus International Collaborating Clinics (SLICC) registry served as a validation cohort.

Main Results:

• A EULAR/ACR score of ≥20 was identified as a threshold indicating higher disease severity.
• Patients with a score of ≥20 exhibited significantly higher AMS scores (p<0.001) and increased likelihood of experiencing flares (p<0.001) within the first five years.
• These patients also showed lower remission rates and greater need for immunosuppressive therapy, findings consistent in the SLICC validation cohort. A significant correlation (r=0.43, p≤0.001) was observed between the EULAR/ACR score and AMS.

Conclusions:

• The EULAR/ACR criteria score of ≥20 serves as a significant indicator of disease ominosity in SLE.
• Patients meeting this threshold demonstrate a more active and severe disease course during the initial five years post-diagnosis.
• These classification criteria provide valuable prognostic information for predicting early-stage SLE disease severity.