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New EULAR/ACR Classification Criteria for SLE: Time for a Change

June 14 2017 11:37 PM ET via RheumReports RheumReports

This afternoon in Madrid, Canada's own Sindhu Johnson presented on the progress of new classification criteria for SLE, which is a joint effort between ACR and EULAR. They are hoping to present the final criteria at ACR in November 2017.

As we know, clinical trials in lupus have unique challenges including heterogeneity of patients and lack of sensitivity of validated outcome measures. Many argue that it is these challenges which lead to negative results in RCTs. By developing new classification criteria for lupus, EULAR/ACR hope to improve standardization of patients included in clinical research, thereby advancing therapeutics.

Embarking on the task of developing lupus classification criteria is a complex job, encompassing multiple methodologic steps. The researchers used some traditional approaches including expert opinion and consensus methods. They also used more rigorous and unique methodologies including measurement science and multi-criteria decision analysis. The result is a set of draft criteria which are WEIGHTED, based on the clinical and laboratory presentation. These criteria give a higher score for more specific SLE manifestations. For example, lupus nephritis class IV is weighted higher than leukopenia or oral ulcers. Based on expert consensus on cases, a score of "84" or higher is significant for classification of SLE. Also important to note are the opening statements, which I find to be very practical.

The final criteria will hopefully be presented at ACR later this year. It is important to remember that these criteria have been designed for research and not for diagnosis. However, I'm sure that they may also be clinically helpful, particularly in the identification of early SLE patients.


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About the Author

Dr. Shahin Jamal
Dr. Shahin Jamal

Dr. Jamal is a Clinical Associate Professor at the University of British Columbia and an active staff physician at Vancouver Coastal Health. Her interests include diagnosis and prognosis of early inflammatory arthritis, and timely assessment and access to care for patients with rheumatoid arthritis.

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