THU0559 The performance of the newly proposed eular/acr classification criteria in juvenile-onset systemic lupus erythematosus-a preliminary study
Authors: S. Sahin, S. Bektas, A. Adrovic, O. Koker, K. Barut, O. Kasapcopur
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The sensitivity and specificity of the ACR-1997 and SLICC-2012 classification criteria in juvenile-onset systemic lupus erythematosus (SLE) are already studied. In previous reports, the main limitations of the ACR-1997 and SLICC-2012 were low sensitivity and low specificity, respectively. To avoid misclassifications, a new set of classification criteria have been developed by the collaboration of the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) and the draft was presented at the 2017 ACR/ARHP Annual Meeting in San Diego, California. After application on 500 SLE patients and 500 controls, the sensitivity and specificity were found as 98% and 97%, respectively. <h3>Objectives</h3> To compare the sensitivity of the new EULAR/ACR criteria with those of the 1997 American College of Rheumatology (ACR) criteria and 2012 Systemic Lupus International Collaborating Clinics criteria in juvenile-onset SLE patients. <h3>Methods</h3> Patients initially were evaluated by ACR-1997, SLICC-2012 and EULAR/ACR classification criteria at baseline, when the diagnosis for the first time had been established by an expert paediatric rheumatologist (OK). All data were obtained from patient records. The diagnostic sensitivity of the three sets of classification criteria were further tested within 1 year of diagnosis and at last patient visit, longitudinally. <h3>Results</h3> A total of 104 juvenile-onset SLE patients were enrolled for the sensitivity performance of classification criteria at diagnosis. Since the follow-up period was less than 1 year, 12 subjects excluded after baseline evaluation. Finally, 92 subjects were eligible for sensitivity evaluation within 1 year of diagnosis and at last visit. The median age at diagnosis of clinician was 13.0 years (range 3.1–17.9 years, interquartile range (IQR) 11.1–16.5 years) with a median disease duration of 5.0 years (IQR 3.0–8.0 years). The female-to-male ratio was 4.7:1. The newly developed EULAR/ACR classification criteria were more sensitive than SLICC-2012 and ACR-1997 at diagnosis (93.3% versus 91.3% and 85.6%, respectively), and at first year (95.7% versus 94.6% and 90.2%, respectively (p&gt;0.05). At last visit the sensitivity of the new set of criteria and SLICC-2012 were same (97.8%), but higher compared to ACR-1997 criteria (95.7%). <h3>Conclusions</h3> Juvenile-onset systemic lupus erythematosus was classified by the newly proposed EULAR/ACR criteria with higher sensitivity compared with SLICC-2012 and ACR-1997 at disease onset and within one year of diagnosis. However, last visit assessment demonstrated equal sensitivity between new EULAR/ACR criteria and SLICC-2012. Although the difference was not significant, the new set of criteria seem to be capable of recruiting more children with juvenile SLE to clinical trials. <h3>Reference</h3> [1] Johnson S. European League Against Rheumatism and American College of Rheumatology present new SLE classification criteria at the 2017 ACR/ARHP annual meeting. Presentation at: ACR/ARHP 2017 Annual Meeting; San Diego, CA 2017November 3–8. <h3>Disclosure of Interest</h3> None declared