THU0011 The SLICC 2012 Classification Criteria Have Higher Sensitivity for SLE than the ACR 1997 Criteria: A Study of 2055 Patients from A Real-Life, Multicenter, International SLE Cohort
Authors: L. Inês, C. Silva, M. Galindo, F. Lopez-Longo, G. Terroso, V. Romão, I. Rúa-Figueroa, M.J. Santos, J. Pego-Reigosa, P. Nero, M. Cerqueira, C. Duarte, L. Miranda, E.R. Almaraz, M. Bernardes, M.J. Gonçalves, A. Raposo, C. Mouriño-Rodriguez, F. Araújo, A. Barcelos, G. Sequeira, T. Nόvoa, M. Couto, P. Abreu, T. Otόn-Sanchez, C. Macieira, F. Ramos, J. Branco, J.A.P. Da Silva, H. Canhão, H. Canhão
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Many patients with a clinical diagnosis of Systemic lupus erythematosus (SLE) do not fulfill the ACR 1997 classification criteria (ACR997). Consequently, patients included in SLE studies might not be representative of the real spectrum of the disease. The new SLICC 2012 classification criteria (SLICC912) were proposed to improve the sensitivity of SLE classification. However, these criteria require external validation. <h3>Objectives</h3> To compare the sensitivity for SLE diagnosis of the ACR997 and SLICC912 classification criteria sets in a real life, multicenter, international SLE population. <h3>Methods</h3> We included in this cross-sectional observational study all patients with a clinical diagnosis of SLE followed at the participating Rheumatology centers and registered in the Portuguese and Spanish national registries (Reuma.pt and RELESSER, respectively). For each patient, we evaluated the fulfillment of the ACR997 and SLICC912 criteria. The sensitivity for SLE diagnosis of each classification set was calculated. We compared the proportion of cases fulfilling ACR997 and SLICC912 using the McNemar9s test. To compare dichotomous variables in two independent populations, we applied a Chi-square or Fisher9s exact test, as appropriate. The statistical significance level was p&lt;0.05. <h3>Results</h3> We included 2055 SLE patients (female = 91.4%; Caucasian =93.5%; age at disease onset = 33.1±14.4; age at SLE diagnosis = 35.3±14.7; age at SLE criteria scoring = 47.4±14.6) from 17 centers. The sensitivity for SLE diagnosis was higher with the SLICC912 (93.1%) compared with the ACR997 (85.6%) (p&lt;0.0001). At least one of the classification criteria sets was fulfilled by 94.7% of cases. From 295 patients not fulfilling the ACR997, 63% could be classified as SLE with SLICC912. In the group of patients with positive SLE classification using the ACR997 criteria, 1.8% did not fulfill the SLICC912. The sensitivity for SLE diagnosis increased with longer disease duration, for both the ACR997 and SLICC912 (p&lt;0.0001). In the group of patients with &lt;5 years since disease onset, there was a larger improved sensitivity of SLICC912 (89.3%) compared to ACR997 (76.0%) (p&lt;0.0001); this difference in sensitivity reduced with longer disease duration, and loses significance for the group with &gt;20 years of disease. <h3>Conclusions</h3> In real-life clinical setting, the SLICC912 classification criteria present a higher sensitivity for SLE compared to ACR997. The SLICC912 might allow a SLE classification earlier in the disease course. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2506