A comparison of the performance of the 2019 European League Against Rheumatism/American College of Rheumatology criteria and the 2012 Systemic Lupus International Collaborating Clinics criteria with the 1997 American College of Rheumatology classification criteria for systemic lupus erythematous in new-onset Chinese patients
Jialin Teng, Junna Ye, Zhuochao Zhou, Cui Lu, Huihui Chi, Xiaobing Cheng, Honglei Liu, Yutong Su, Hui Shi, Yue Sun, Chengde Yang
Abstract
Background New criteria published by the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) use a point system that gives varying weight to each of 22 criteria. The aim of this study was to compare the performance of the 2019 EULAR/ACR criteria and the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria with the 1997 ACR criteria in a Chinese cohort. Methods A cross-sectional observation study of patients with a clinical diagnosis of SLE was performed. We collected 199 new-onset SLE patients and 175 control subjects. The data were retrospectively collected to establish the patients who fulfilled the 1997 ACR, 2012 SLICC and 2019 EULAR/ACR criteria. The sensitivity and specificity of the three classification criteria were compared using McNemar’s test. Results The sensitivity and specificity of the 2019 EULAR/ACR criteria were 96.5% and 90.3%, respectively. For the 2012 SLICC criteria, the sensitivity and specificity were 92.0% and 84.0%, respectively, while for the 1997 ACR criteria, these two values were 75.4% and 96.0%. Leucopaenia (62%), arthritis (54%) and autoimmune haemolysis (45%) were the most frequently observed clinical manifestations in the group that fulfilled the 2019 EULAR/ACR criteria. Fever was reported by 39% of participants. Conclusion Compared with the 1997 ACR and 2012 SLICC criteria, the 2019 EULAR/ACR criteria performed best in terms of sensitivity but less well in terms of specificity in Chinese new-onset lupus patients.